Value of shear wave elastography in diagnosing biliary atresia by ultrasonography

Abstract

Objective To investigate the value of the shear wave elastography (SWE) in the diagnosis of biliary atresia (BA) in infants by ultrasonography. Methods SWE was used to measure the liver stiffness measurement(LSM) of 138 infants. Following surgical or pathological diagnosis, the infants were subclassified into BA and non-biliary atresia (non-BA) groups. ROC analysis was used to determine the sensitivity and specificity of LSM, the ultrasonic findings in the differential diagnosis of suspected BA, and the cut-off value to diagnose BA. Results Of the 138 infants with cholestatic hepatitis, 51 were diagnosed as BA group and 87 cases were assigned to the non-BA group. The ROC analysis showed the cut-off value of LSM for diagnosis of biliary atresia in children with jaundice was 12.35 kPa, the AUC was 0.936, and the sensitivity and specificity were 84.3% and 89.7%, respectively.In the parallel test, the triangular cord (TC) sign combined with abnormal gallbladder (AbGB) had the best diagnostic performance in all patients. However, in patients older than 30 days, the LSM combined with TC had the best AUC(0.987) and diagnostic performance(98.6%) like with TC combined with AbGB. Conclusions Both SWE and gray scale ultrasound have higher diagnostic performance for BA. LSM can be used as a valuable index for diagnosing BA by ultrasound. Key words: Ultrasonography; Shear wave elastography; Infant; Liver; Biliary atresia