Ultrasound differential diagnosis of hepatic hilar cystic lesions in neonates and infants / 中国小儿急救医学

ABSTRACT

Objective To explore the value of ultrasound in differential diagnosis of hepatic hilar cyst in neonates and infants. Methods The ultrasonographic characteristics of 93 children with hilar cysts under 6 months of age admitted to the General Surgery Department of Beijing Children′s Hospital. Affiliated to Capital Medical University from January 2014 to December 2018 were retrospectively analyzed. According to the surgical results,they were divided into two groupscystic biliary atresia ( CBA) group and congenital choledochal cyst (CC) group,21 cases in the CBA group and 72 cases in the CC group. The size of cyst in hepatic portal area,the shape of gallbladder in empty stomach,the expansion of intrahepatic and extrahepatic bile ducts,the deposition of biliary sludge and the communication between cyst and intrahepatic bile duct were observed by ultrasound. Results The cyst volume of CBA group was 0. 4 ( 0. 1, 1. 3 ) cm3 , and that of CC group was 18. 3(5. 4,50. 3) cm3. The cyst volume of CBA group was significantly smaller than that of CC group (P<0. 01);19 cases had abnormal gallbladder morphology in CBA group and 4 cases in CC group (P<0. 01);1 case had biliary sludge in hilar cyst in CBA group and 51 cases had biliary sludge in cyst in CC group ( P <0. 01);no intrahepatic bile duct dilatation was observed in CBA group,and 54 cases had intrahepatic bile duct dilatation in CC group (P<0. 01);no cyst communicated with intrahepatic bile duct in CBA group,and all cysts communicated with intrahepatic bile duct in CC group (P <0. 01). Conclusion Gallbladder shape,cyst size,biliary sludge deposition,intrahepatic bile duct dilatation and the communication between cyst and intrahepatic bile duct can be used as sonographic features to differentiate CBA from CC.