Magnetic resonance cholangiography for evaluation of cholestatic jaundice neonates and infants
Journal
Journal of the Formosan Medical Association
Journal Volume
97
Journal Issue
10
Pages
698-703
Date Issued
1998
Author(s)
Abstract
Distinguishing extrahepatic biliary atresia from other causes of cholestasis in neonates and infants is important because surgical intervention before 2 months of age allows for long-term survival. The purpose of this prospective study was to evaluate the usefulness of magnetic resonance (MR) cholangiography in differentiating biliary atresia from other causes of cholestatic jaundice in neonates and infants. Nine anicteric infants (control group) aged 10 to 224 days (mean ± SD, 8 ± 65 days) and 15 neonates and infants with cholestatic jaundice, aged 22 to 142 days (mean ± SD, 71 ± 37) underwent MR cholangiography. The final diagnosis of extrabiliary atresia (6 patients) was based on laparotomy findings (4 patients) or autopsy (2 patients), while neonatal hepatitis (9 patients) was diagnosed according to the liver biopsy findings and clinical recovery during follow-up. Percutaneous liver biopsies were performed in all 15 patient. Results showed that the gall bladder and common bile duct (CBD) could be visualized using MR cholangiography in all patients in the control group. Nonvisualization of the CBD (6/6 patients) and demonstration of a small gall bladder (6/6 patients) characterized MR cholangiography findings in patients with biliary atresia. MR cholangiography failed to depict the CBD in one infant with hepatitis. We conclude that demonstration of the CBD by MR cholangiography in neonates and infants with cholestasis can be used to exclude the diagnosis of biliary atresia. In patients with cholestatic jaundice considered for exploratory laparotomy, preoperative MR cholangiography is recommended to avoid unnecessary surgery.
SDGs
Other Subjects
article; bile duct atresia; cholangiography; clinical article; diagnostic accuracy; diagnostic imaging; diagnostic value; differential diagnosis; female; human; liver biopsy; male; newborn; newborn disease; nuclear magnetic resonance; obstructive jaundice; Biliary Atresia; Cholestasis; Common Bile Duct; Diagnosis, Differential; Female; Gallbladder; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Prospective Studies
Type
journal article