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Diagnostic Performance of Sonographic Features in Patients With Biliary Atresia: A Systematic Review and Meta‐analysis
Author(s) -
Yoon Hee Mang,
Suh Chong Hyun,
Kim Jeong Rye,
Lee Jin Seong,
Jung Ah Young,
Cho Young Ah
Publication year - 2017
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14234
Subject(s) - medicine , biliary atresia , meta analysis , atresia , cord , confidence interval , cholestasis , radiology , receiver operating characteristic , bile duct , gallbladder , common bile duct , gastroenterology , surgery , liver transplantation , transplantation
Objectives To evaluate the diagnostic performance of sonographic features of biliary atresia in patients with infantile cholestasis. Methods The Ovid‐MEDLINE and EMBASE databases were searched for studies of the diagnostic performance of sonographic features of biliary atresia in patients with infantile cholestasis. A meta‐analysis was performed to evaluate the diagnostic performance of the triangular cord sign and other sonographic features in patients with biliary atresia. Results Seventeen eligible studies with 1444 patients were included. The triangular cord sign had high accuracy for diagnosing biliary atresia: the meta‐analytic summary sensitivity and specificity were 85% (95% confidence interval, 77%–90%) and 97% (95% confidence interval, 94%–99%), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.97. Meta‐regression analysis revealed that the cutoff thickness of the triangular cord sign (3 or 4 mm) was a significant factor affecting study heterogeneity ( P < .01). The proportions of nonidentification of the gallbladder (GB) ranged from 0% to 53%. Abnormal GB morphologic characteristics, nonvisualization of the common bile duct, and the presence of hepatic subcapsular flow showed relatively high sensitivities and specificities. Conclusions The triangular cord sign and other sonographic features, including abnormal GB morphologic characteristics, nonvisualization of the common bile duct, and the presence of hepatic subcapsular flow, had high diagnostic performance for the diagnosis of biliary atresia.