Biliary atresia (BA) is a common progressive and obstructive pathological change of the intrahepatic and extrahepatic duct, often causing cirrhosis immediately and leading to death. Prompt and accurate early diagnosis determines its optimal operation opportunity and therapeutic efficacy. With the unceasing updating of ultrasonic apparatus, especially the application of high resolution detecting head, the sonogram is becoming more and more clear, and more and more doctors have investigated and accumulated experiences in the ultrasonic diagnosis for BA. However, there have been no general and unitive diagnostic criteria up to now.
A research article to be published on 14 June 2008, in the World Journal of Gastroenterology addresses this question. By cross section scan of the right branch of portal vein, it can be seen that the triangular cord adhered tightly to its right anterior area. Cross section scan of the right branch of portal vein was easier to show the triangular cord compared with longitudinal section scan, making it easier to be mastered by learners.
The triangular cord can be observed at the porta hepatis (thickness: 0.3 cm-0.6 cm) in 10 patients with biliary atresia. Smaller triangular cord (0.2 cm-0.26 cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and hetreogeneous echogenicity. Statistical analysis was performed to compare hepatomegaly and hetreogeneous echogenicity and the stage of hepatic fibrosis.
The present study considered that the presence of the triangular cord at the porta hepatis was specific, However, it was not the only diagnostic criteria, since flat and small gallbladder and poor contraction were also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and hetreogeneous echogenicity was proportional with liver fibrosis, and was able to indicate the duration of course and prognosis.