European Radiology

, Volume 28, Issue 4, pp 1771–1777 | Cite as

Early US findings of biliary atresia in infants younger than 30 days

  • Sook Min Hwang
  • Tae Yeon JeonEmail author
  • So-Young Yoo
  • Yon Ho Choe
  • Suk-Koo Lee
  • Ji Hye Kim



To investigate and compare ultrasound (US) findings for the diagnosis of biliary atresia (BA) in infants younger than 30 days with those of infants older than 30 days.

Materials and Methods

From 2000 to 2015, we reviewed hepatobiliary US images in 12 BA infants younger than 30 days (younger BA group) and 62 BA infants older than 30 days (older BA group) before Kasai procedure. Eight (67%) of younger BA group underwent follow-up US examinations before Kasai procedure. Our review of the images focused on triangular cord sign, gallbladder (GB) abnormalities, vascular changes, and signs of portal hypertension.


The triangular cord sign was present in 17% of younger BA group and in 56% of older BA group (P=.024). GB abnormalities were commonly identified in both groups. The hepatic artery diameter was significantly smaller in younger BA group than in older BA group (P<.001). Signs of portal hypertension were less common in younger BA group (17%) than in older BA group (84%) (P<.001). Follow-up US of two infants in younger BA group showed a new appearance of the triangular cord sign.


BA infants younger than 30 days showed atypical US findings compared with those older than 30 days.

Key Points

BA infants younger than 30 days show atypical US findings.

GB abnormalities were common in both younger and older BA group.

Subsequent US examination may be helpful to diagnose BA in young infants.


Biliary atresia Ultrasound Paediatric imaging Hepatobiliary imaging Infant 



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Tae Yeon Jeon.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• case-control study

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Sook Min Hwang
    • 1
  • Tae Yeon Jeon
    • 1
    Email author
  • So-Young Yoo
    • 1
  • Yon Ho Choe
    • 2
  • Suk-Koo Lee
    • 3
  • Ji Hye Kim
    • 1
  1. 1.Department of RadiologySamsung Medical Centre, Sungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of PaediatricsSamsung Medical Centre, Sungkyunkwan University School of MedicineSeoulKorea
  3. 3.Department of SurgerySamsung Medical Centre, Sungkyunkwan University School of MedicineSeoulKorea

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