Is “gallbladder length-to-width ratio” useful in diagnosing biliary atresia?
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Read the article on jpedsurg.org ↗Article · Feb 2019 · 1 min read
In brief
In brief
Study validates gallbladder length-to-width ratio as an objective ultrasound parameter for biliary atresia screening in infants with conjugated hyperbilirubinemia. Combined assessment of gallbladder LTWR >4.1, portal vein diameter >4.4mm, and hepatic artery diameter >1.2mm achieves 98% specificity for BA diagnosis.
Written by the GCMD Library team from the article.
Background
The accurate assessment of gallbladder shape and wall abnormalities by ultrasound (US) in diagnosing biliary atresia (BA) remains a subjective determination. The objective of this study was to examine the reliability of gallbladder length-to-width ratio (LTWR) by US measurement for diagnosis of BA.
Methods
One hundred infants with conjugated hyperbilirubinemia and unknown cause of jaundice who underwent transabdominal US from February 2009 to February 2017 were enrolled. The gallbladder classification and other detailed US findings were reviewed.
Results
There were statistical differences in gallbladder lumen, classification, length, width and LTWR of gallbladder (all P 4.4 mm, hepatic artery (HA) diameter > 1.2 mm, and gallbladder LTWR >4.1, provided much higher specificity (98%), odds ratio (11), and positive likelihood ratio (LR+) (10.6).
Conclusion
The gallbladder LTWR by US could be a suggestive US parameter for BA screening. The triad of PV diameter, HA diameter, and gallbladder LTWR yielded the highest specificity, odds ratio, and LR+ for diagnosing BA.
Level of evidence
Level III study of diagnostic test.