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Ultrasound characteristics combined with gamma-glutamyl transpeptidase for diagnosis of biliary atresia in infants less than 30 days

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Abstract

Purpose

To retrospectively assess the diagnostic performance of grey-scale ultrasound (US) characteristics and gamma-glutamyl transpeptidase (GGT) alone or combined in distinguishing biliary atresia (BA) from other cholestasis diseases in infants younger than 30 days.

Materials and methods

Between January 2012 and October 2020, the demographic characteristics, laboratory results and US characteristics of 35 BA and 52 non-BA infants younger than 30 days were retrospectively evaluated. Areas under the receiver operating characteristic curves (AUCs) were used to estimate the probability of predicting BA, which were compared by DeLong test.

Results

The diagnostic performance of gallbladder classification in identifying BA was higher than that of fibrotic cord thickness (AUC 0.900 vs. 0.771, P = 0.03). With the cutoff level of 188 IU/L, serum GGT had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 77.1%, 69.2%, 62.8%, and 81.8%, respectively. Combined with gallbladder classification and GGT, the sensitivity, specificity, PPV, NPV and accuracy were 100.0%, 63.5%, 64.8%, 100.0% and 78.2%.

Conclusions

Gallbladder classification was more valuable than fibrotic cord thickness in the diagnosis of BA among infants less than 30 days. Combined with gallbladder classification and GGT, the sensitivity for the diagnosis of BA can reach 100.0%.

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Abbreviations

BA:

Biliary atresia

GGT:

Gamma-glutamyl transpeptidase

TC:

Triangular cord

TB:

Total bilirubin

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

ROC:

Receiver operating characteristic

PPV:

Positive predictive value

NPV:

Negative predictive value

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Acknowledgements

This study was supported by Guangdong Basic and Applied Basic Research Foundation [Grant Number: 2019A1515010549].

Funding

This work was supported by Guangdong Basic and Applied Basic Research Foundation [Grant Number: 2019A1515010549].

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Authors and Affiliations

  1. Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Er Road, Guangzhou, 510080, People’s Republic of China

    Guotao Wang, Nan Zhang, Xiaoer Zhang, Wenying Zhou, Xiaoyan Xie & Luyao Zhou

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  1. Guotao Wang
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  2. Nan Zhang
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  4. Wenying Zhou
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Correspondence to Luyao Zhou.

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Wang, G., Zhang, N., Zhang, X. et al. Ultrasound characteristics combined with gamma-glutamyl transpeptidase for diagnosis of biliary atresia in infants less than 30 days. Pediatr Surg Int 37, 1175–1182 (2021). https://doi.org/10.1007/s00383-021-04923-0

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