Diagnostic Value of Ultrasonography in Biliary Ducts Atresia

Cholestatic jaundice in early infancy is an important clinical condition. Idiopathic neonatal hepatitis and extra-hepatic biliary atresia (EHBA) is two main of different etiology, and it's necessary to distinguish between these two entities. It is important that EHBA be rapidly diagnosed, because an immediate surgery may prevent further potentially fatal consequences. A rapid, ubiquitous, non-invasive and accurate technique with the least complications is crucial for early diagnosis of EHBA. The hepatobiliary scan identifies diseased gallbladders and bile drainage problems, and ultrasonography is an easy and cheap method of survey of biliary tract. In this study, we evaluated and compared two different diagnostic method, ultrasonography and HIDA scan for this purpose. Method & Materials: In these two years prospective study ultrasonography, HIDA scan and liver biopsy was performed in a group of patients with cholestasis. We considered the result of liver biopsy as the gold standard. Accordingly sensitivity, specificity, positive and negative predictive values and accuracy of ultrasonography and HIDA scan were calculated and compared together. Sixty infants, 35 males and 25 females mean age (56.1±17.8 days) were studied According to the results of liver biopsy, there were 16 (26.7%) cases of EHBA, and 24 (40%) cases of idiopathic hepatitis. Ultrasonography detected EHBA in 15 cases and HIDA scan diagnosed it in 38 patients. Sensitivity, specificity, positive predictive values, negative predictive value and accuracy of ultrasonography were 87.5%, 97.7%, 93.3%, 95.7%, and HIDA scan, these value were 100%, 50%, 42.1%, 100% respectively. This study showed a lower sensitivity but higher specificity of ultrasonography for diagnosis of EHBA in compared with HIDA scan