| Objective: Clinical symptoms, laboratory examination and audio-visual chart in biliary atresia and non-biliary atresia jaundice have some overlaps, but the treatment and prognosis are completely different,so early identification is especially important. This study was designed to investigate the diagnostic value of ultrasound in biliary atresia and non-biliary atresia infant jaundice, so as to provide a theoretical basis for clinical; Through the measured Elastic parameters by acoustic radiation force impulse(acoustic radiation force impulse, ARFI) study whether it has Correlation with Liver FibrosisMethods: We selected 60 cases in August 2014- November 2015 of pathological jaundice patients admitted in our hospital outpatient and hospitalization as the case group, divided into biliary atresia jaundice group 22 cases and non-biliary atresia jaundice group 30 cases,20 cases of control group. With PHILIPS-IU22 color Doppler ultrasonography measuring gallbladder size and gallbladder shrinkage, the hepatic artery diameter size, to observe the shape and structure of the gallbladder,in front of fiber block and blood flow to the liver capsule. Application of Siemens Acuson S 2000 color ultrasonic diagnostic instrument, configuration ARFI imaging software, measuring shear wave velocity(shear wave velocity, SWV), the evaluation of liver fibrosis.Results: 1 The sonographic findings of gallbladder situation in different group 1.1 The ultrasonography comparison of gallbladder size in different groups: The gallbladder length and width in biliary atresia group were less than the non-biliary atresia group and normal control group, statistical significance exist between the former and the latter two, no statistical significance between the latter two. 1.2 The ultrasonography comparison of gallbladder shape in different groups: The gallbladder shape is different in different groups, 22 cases of biliary atresia jaundice group gallbladder form: 1 case of filling, 15 cases of wilting,6 cases without cavity or gallbladder. 30 cases of non-biliary atresia jaundice group gallbladder form: 25 cases of filling, 4 cases of wilting,1 case without cavity or gallbladder. 20 cases of normal control group gallbladder form:all filling. 1.3 The ultrasonography comparison of gallbladder shrinkage in different groups:The biliary atresia jaundice group : 15 cases did not see the gallbladder contraction, 7 cases of shrinkage rate <50%, No shrinkage rate > 50%. Non-biliary atresia jaundice group: 3 cases did not see the gallbladder contraction, 9 cases of shrinkage rate <50%, 18 cases of shrinkage rate > 50%.20 cases of normal control group all the shrinkage rate > 50%. 2 The sonographic findings in liver conditions in different group 2.1 The sonographic findings comparison of hepatic subcapsular blood flow in different groups:The biliary atresia jaundice group: 21 cases occurred subcapsular blood, 1 cases no subcapsular blood flow. Non-biliary atresia jaundice group: 6 cases occurred subcapsular blood,24 cases no subcapsular blood flow. Normal control group: no cases occurred subcapsular blood flow.the three groups existed differences. 2.2 The sonographic findings of blocks in front of hepatic fibrosis(triangular cord sign, TC sign) in different groups:The biliary atresia jaundice group had 16 cases of hepatic fibrous plaques,6 cases did not see fibrous plaques. Non-biliary atresia jaundice group and normal control group were no fibrous plaque 2.3 Hepatic artery diameter, the maximum velocity and resistance index(RI) in the comparison of different groups:Biliary atresia jaundice group than non- biliary atresia jaundice group and normal control group wider diameter, maximum velocity faster, RI increased. The former existed differences with the latter two and the differences were statistically significant. But there was no significant difference between the latter two. 2.4 Acoustic radiation force impulse imaging findings 2.4.1 The Liver shear wave velocity comparison between different degree of liver fibrosis:Liver pathology grade namely F0~F4. Biliary atresia jaundice group:F0 group 0 cases, liver SWV in F1,F2,F3 and F4 group Ascending order,differences had significant statistical significance(F=18.044, P < 0.001). Further comparison between the two groups showed,SWV differences between the groups F1 and F2,F1 and F3, F1 and F4, F2 and F3, F2 and F4 and F3 and F4 differences all had statistical significance(P<0.05). SWV value and liver fibrosis pathological grading had obvious relevance. 2.4.2 The liver shear wave velocity comparison in different types of jaundice:Biliary atresia jaundice group, non-biliary atresia jaundice group and normal control group liver shear wave velocity had differences. Biliary atresia jaundice group liver SWV was obviously higher than that of non-biliary atresia jaundice group SWV and normal control group, the difference was statistically significant. Non- biliary atresia jaundice group liver SWV compared with normal control group, there was no statistically significant difference.Conclusion: 1 Gallbladder form and shrinkage had a great reference value in the diagnosis of biliary atresia and non- biliary atresia jaundice. Biliary atresia no one case of gallbladder shrinkage rate> 50%, It played a significant role in the diagnosis of biliary atresia. 2 None exist blocks in front of the liver fibrosis in non-biliary atresia jaundice children. It had important diagnostic value in the diagnosis of biliary atresia. 3 Blood flow to the liver capsule and hepatic artery diameter, flow velocity, resistance index in the diagnosis of biliary atresia had certain supplementary role. It should be combined with other tests comprehensive judgment. 4 ARFI as a non-invasive, convenient way to evaluate the degree of liver fibrosis, gradually recognized by people, it can quantitatively evaluate liver tissue hardness.So it can objectively evaluate the progress of the disease and prognosis of children with biliary atresia. |
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