Application Of Ultrasound In Differential Diagnosis Of Cystic Biliary Atresia And Congenital Choledochal Cyst

Objective To investigate the differences of infantile cystic biliary atresia(CBA)and congenial choledochal cyst(CCC)in ultrasound findings.Methods A retrospective study was performed on 51 cases of ultrasonography diagnosed as "hepatic portal cystic lesions" in our hospital from 2015 to 2018 with the age less than 6 months old.The patients were diagnosed as biliary atresia or choledochal cyst by surgical treatment.The liver function indexes,including total bilirubin,direct bilirubin,indirect bilirubin,alanine aminotransferase,aspartate aminotransferase,glutamine transpeptidase,alkaline phosphatase,lactate dehydrogenase,serum albumin,and bile acid levels were observed.And the sonographic findings of cyst size,gallbladder size and morphology,triangular cord sign,intrahepatic bile duct,hepatic artery,bile mud deposits,spleen thickness etc.were explored.Results Of the 51 patients,26 patients were the CBA and 25 were the CCC.The female patients were more significantly than the male patients.Among the liver function indexes,total bilirubin,direct bilirubin,aspartate aminotransferase,glutamine transpeptidase and bile acid levels were different statistically(P<0.05).The sonographic findings of the triangular cord sign,the length of the cyst,the diameter of the cyst,bile mud deposits,the abnormal gallbladder,the dilatation of the intrahepatic bile duct,the widening of the hepatic artery,and the thickness of the spleen were different statistically(P<0.05).The accuracy of ultrasound diagnosis of CBA and CCC was 65.4% and 92%,respectively.There were no significant differences in other liver function indexes and sonographic findings(P>0.05).Conclusion In infants with cystic biliary atresia and choledochal cysts,there are somedifferences in liver function indexes and sonographic findings.The diameter of length and width of cysts in children with CCC are significantly larger than those in CBA group,and bile mud deposits can be found more in CCC group.The incidence of triangular cord sign,abnormal gallbladder,hepatic artery widening and splenomegaly in the CBA group was significantly higher than that in the CCC group.Ultrasound imaging has the advantages in the differential diagnosis of CBA and CCC with a high accuracy,simplicity and quick.