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MRI-based decision tree model for diagnosis of biliary atresia

 Yong Hee Kim  ;  Myung-Joon Kim  ;  Hyun Joo Shin  ;  Haesung Yoon  ;  Seok Joo Han  ;  Hong Koh  ;  Yun Ho Roh  ;  Mi-Jung Lee 
 European Radiology, Vol.28(8) : 3422-3431, 2018 
Journal Title
 European Radiology 
Issue Date
Biliary atresia ; Decision trees ; Jaundice ; Magnetic resonance imaging ; Paediatrics
OBJECTIVES: To evaluate MRI findings and to generate a decision tree model for diagnosis of biliary atresia (BA) in infants with jaundice. METHODS: We retrospectively reviewed features of MRI and ultrasonography (US) performed in infants with jaundice between January 2009 and June 2016 under approval of the institutional review board, including the maximum diameter of periportal signal change on MRI (MR triangular cord thickness, MR-TCT) or US (US-TCT), visibility of common bile duct (CBD) and abnormality of gallbladder (GB). Hepatic subcapsular flow was reviewed on Doppler US. We performed conditional inference tree analysis using MRI findings to generate a decision tree model. RESULTS: A total of 208 infants were included, 112 in the BA group and 96 in the non-BA group. Mean age at the time of MRI was 58.7 ± 36.6 days. Visibility of CBD, abnormality of GB and MR-TCT were good discriminators for the diagnosis of BA and the MRI-based decision tree using these findings with MR-TCT cut-off 5.1 mm showed 97.3 % sensitivity, 94.8 % specificity and 96.2 % accuracy. CONCLUSIONS: MRI-based decision tree model reliably differentiates BA in infants with jaundice. MRI can be an objective imaging modality for the diagnosis of BA. KEY POINTS: • MRI-based decision tree model reliably differentiates biliary atresia in neonatal cholestasis. • Common bile duct, gallbladder and periportal signal changes are the discriminators. • MRI has comparable performance to ultrasonography for diagnosis of biliary atresia.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
고홍(Koh, Hong) ORCID logo https://orcid.org/0000-0002-3660-7483
김명준(Kim, Myung Joon) ORCID logo https://orcid.org/0000-0002-4608-0275
신현주(Shin, Hyun Joo) ORCID logo https://orcid.org/0000-0002-7462-2609
윤혜성(Yoon, Haesung) ORCID logo https://orcid.org/0000-0003-0581-8656
이미정(Lee, Mi-Jung) ORCID logo https://orcid.org/0000-0003-3244-9171
한석주(Han, Seok Joo) ORCID logo https://orcid.org/0000-0001-5224-1437
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