caa a22 4500 475756371 CHVBK 20180406123539.0 cr unu---uuuuu 170329e20000101xx s 000 0 eng 10.1007/s002470050017 doi (NATIONALLICENCE)springer-10.1007/s002470050017 Making the diagnosis of biliary atresia using the triangular cord sign and gallbladder length [Elektronische Daten] [Anne P. Tan Kendrick, K. B. Phua, B. C. Ooi, R. Subramaniam, C. E. Tan, A. S.W. Goh] Abstract.: Background. To evaluate the accuracy and utility of the triangular cord sign and gallbladder length in diagnosing biliary atresia by sonography.¶Materials and methods. Sixty fasted infants with cholestatic jaundice aged 2-12 weeks were examined sonographically using a 5-10 MHz linear array transducer, focusing on the triangular cord sign (as described by Choi et al. [1]), the gallbladder, and ducts. The triangular cord is defined as a triangular or tubular echogenic density seen immediately cranial to the portal vein bifurcation; it represents the fibrotic remnant of the obliterated cord in biliary atresia. The findings were blinded to blood chemistry, 99 mTc-DISIDA hepatobiliary scintigraphy, and liver biopsy. Diagnosis of biliary atresia was confirmed at surgery and histology. Non-biliary atresia infants resolved medically. Comparative charges of the various investigations was made.¶Results. Twelve infants had biliary atresia, and ten demonstrated a definite triangular cord. The two false-negatives had small or nonvisualized gallbladders. No false-positives were recorded. Gallbladder length ranged from 0-1.45 cm with a mean of 0.52 cm in biliary atresia compared to a mean of 2.39 cm in nonbiliary atresia infants. 99 mTc-DISIDA hepatobiliary scintigraphy showed no excretion (false-positive) in 23 % of nonbiliary atresia cases. Scintigraphy and liver biopsy charges were 2 and 6 times that of sonography, respectively.¶Conclusion. The triangular cord sign and gallbladder length together are noninvasive, inexpensive, and very useful markers for biliary atresia. Springer-Verlag Berlin Heidelberg, 2000 Tan Kendrick Anne P. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut Phua K. B. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut Ooi B. C. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut Subramaniam R. Department of Paediatric Surgery, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899 aut Tan C. E. Department of Paediatric Surgery, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899 aut Goh A. S.W. Department of Nuclear Medicine, Singapore General Hospital, Outram Road, Singapore 169608 aut https://doi.org/10.1007/s002470050017 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002470050017 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tan Kendrick Anne P. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut NATIONALLICENCE 700 1- Phua K. B. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut NATIONALLICENCE 700 1- Ooi B. C. Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899s aut NATIONALLICENCE 700 1- Subramaniam R. Department of Paediatric Surgery, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899 aut NATIONALLICENCE 700 1- Tan C. E. Department of Paediatric Surgery, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899 aut NATIONALLICENCE 700 1- Goh A. S.W. Department of Nuclear Medicine, Singapore General Hospital, Outram Road, Singapore 169608 aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer