Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Eur Radiol. 2018 Aug;28(8):3422-3431. doi: 10.1007/s00330-018-5327-0. Epub 2018 Feb 23.
To evaluate MRI findings and to generate a decision tree model for diagnosis of biliary atresia (BA) in infants with jaundice.
We retrospectively reviewed features of MRI and ultrasonography (US) performed in infants with jaundice between January 2009 and June 2016 under approval of the institutional review board, including the maximum diameter of periportal signal change on MRI (MR triangular cord thickness, MR-TCT) or US (US-TCT), visibility of common bile duct (CBD) and abnormality of gallbladder (GB). Hepatic subcapsular flow was reviewed on Doppler US. We performed conditional inference tree analysis using MRI findings to generate a decision tree model.
A total of 208 infants were included, 112 in the BA group and 96 in the non-BA group. Mean age at the time of MRI was 58.7 ± 36.6 days. Visibility of CBD, abnormality of GB and MR-TCT were good discriminators for the diagnosis of BA and the MRI-based decision tree using these findings with MR-TCT cut-off 5.1 mm showed 97.3 % sensitivity, 94.8 % specificity and 96.2 % accuracy.
MRI-based decision tree model reliably differentiates BA in infants with jaundice. MRI can be an objective imaging modality for the diagnosis of BA.
• MRI-based decision tree model reliably differentiates biliary atresia in neonatal cholestasis. • Common bile duct, gallbladder and periportal signal changes are the discriminators. • MRI has comparable performance to ultrasonography for diagnosis of biliary atresia.
评估磁共振成像（MRI）表现并建立用于诊断婴儿黄疸型胆道闭锁（BA）的决策树模型。
我们回顾性分析了 2009 年 1 月至 2016 年 6 月期间经机构审查委员会批准，在患有黄疸的婴儿中进行的 MRI 和超声（US）的特征，包括 MRI（MR 三角纤维带厚度，MR-TCT）或 US（US-TCT）上的门静脉周围信号改变的最大直径、胆总管（CBD）的可视性和胆囊（GB）的异常。在多普勒 US 上观察肝包膜下血流。我们使用 MRI 结果进行条件推理树分析，以生成决策树模型。
共纳入 208 例婴儿，BA 组 112 例，非 BA 组 96 例。MRI 时的平均年龄为 58.7±36.6 天。CBD 的可视性、GB 的异常和 MR-TCT 是诊断 BA 的良好鉴别指标，使用这些发现并以 MR-TCT 截断值 5.1mm 构建的基于 MRI 的决策树显示 97.3%的灵敏度、94.8%的特异性和 96.2%的准确性。
基于 MRI 的决策树模型可靠地区分了黄疸型婴儿中的 BA。MRI 可以作为诊断 BA 的客观影像学方法。
• 基于 MRI 的决策树模型可靠地区分了新生儿胆汁淤积性 BA。• 胆总管、胆囊和门静脉周围信号改变是鉴别指标。• MRI 在诊断 BA 方面与 US 具有可比性。
