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胆道閉鎖症(小児科)

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img  2:  Hepatic arterial diameter measured with US: adjunct for US diagnosis of biliary atresia.
 
著者: Woo Sun Kim, Jung-Eun Cheon, Byung Jae Youn, So-Young Yoo, Wha Young Kim, In-One Kim, Kyung Mo Yeon, Jeong Kee Seo, Kwi-Won Park
雑誌名: Radiology. 2007 Nov;245(2):549-55. doi: 10.1148/radiol.2452061093. Epub 2007 Sep 21.
Abstract/Text PURPOSE: To prospectively evaluate the accuracy of hepatic artery diameter and hepatic artery diameter-to-portal vein diameter ratio for ultrasonographic (US) diagnosis of biliary atresia, with cholangiographic or clinical information as reference standard.
MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. US was performed in 68 neonates and infants with cholestatic jaundice (mean age, 61 days; male-to-female ratio, 38:30). Biliary atresia (n = 38) was confirmed with cholangiography, and hepatitis (n = 30) was diagnosed with clinical (n = 24) or cholangiographic (n = 6) findings. Diameter of the right hepatic artery was measured with US. Right hepatic artery diameter-to-right portal vein diameter ratio was measured to determine relative enlargement of the hepatic artery. As a control group, 17 neonates and infants (mean age, 67 days; male-to-female ratio, 12:5) without jaundice underwent US of the porta hepatis. Statistical analysis was performed to compare US parameters among three groups with one-way analysis of variance. Optimal cutoff values of the hepatic artery diameter and hepatic artery diameter-to-portal vein diameter ratio for biliary atresia diagnosis were obtained with receiver operating characteristic analysis.
RESULTS: The diameter of the right hepatic artery in biliary atresia group (1.9 mm +/- 0.4 [standard deviation]) was significantly larger than that in the hepatitis (1.4 mm +/- 0.3) and control (1.2 mm +/- 0.2) groups (P < .001). Hepatic artery diameter-to-portal vein diameter ratio in the biliary atresia group (0.52 +/- 0.12) was larger than that in hepatitis (0.40 +/- 0.07) and in control (0.40 +/- 0.10) groups (P < .001). Optimum cutoff values for diagnosis of biliary atresia were 1.5 mm (sensitivity, 92%; specificity, 87%; accuracy, 89%) for hepatic artery diameter and 0.45 for hepatic artery diameter-to-portal vein diameter ratio (sensitivity, 76%; specificity, 79%; accuracy, 78%).
CONCLUSION: Measurement of hepatic artery diameter can be helpful in the US diagnosis of biliary atresia.

PMID 17890351  Radiology. 2007 Nov;245(2):549-55. doi: 10.1148/radiol.2452061093. Epub 2007 Sep 21.
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