Hee Jung Lee MD, Abstract Co-Author: Nothing to Disclose

Young Hwan Kim MD, Presenter: Nothing to Disclose

Mi Jeong Kim MD, Abstract Co-Author: Nothing to Disclose

JoongHyuk Kwon, Abstract Co-Author: Nothing to Disclose

To propose an imaging grading system and to correlate with clinical status in long-term survivals of biliary atresia following the Kasai Portoenterostomy.

Forty-four MR (25) or CT (19) findings in 33 patients (7 months -19 years old) of biliary atresia following the Kasai portoenterostomy (follow-up period, 5 months - 19 years) were retrospectively evaluated. Image findings were assessed for three patterns of A, B, and C, according to the gross morphology of the liver, the status of intrahepatic bile duct (IHD), and the degree of portal hypertension, respectively. Pattern A was divided into I (normal or mild hepatomegaly), II (nodular contour without a giant regenerative nodule), and III (nodular contour with a giant regenerative nodule). Pattern B was divided into a (no demonstrable IHD dilatation), b (IHD dilatation without segmental atrophy), and c (IHD dilatation with segmental atrophy). Pattern C was calculated by sum of scores for the four parameters; parenchymal homogeneity of the liver (0-1), degree of splenomegaly (1-3), degree of varices or collaterals (1-3), and amount of ascites (1-2). Imaging grading was recorded as pattern A-B-C such as I-b-4. Clinical status of patients was divided into three groups (I, II, III) on the bases of the serum level of total bilirubin, ALP, and AST. Statistical analysis was performed to evaluate the correlation between the imaging grading system and clinical status.

Numbers of pattern A (I, II, III) - pattern B (a, b, c) - pattern C (score of portal hypertension) were pattern A (3, 18, 23) - pattern B (18, 19, 7) - pattern C (ranged 1-8), respectively. Clinical statuses of group I, II, III were 15, 15, and 13, respectively. There were statistical correlations between all three patterns and the clinical status (p < 0.05). There were also statistical correlation between pattern A and C (p = .000), and pattern B and C (p = .011).

Our imaging grading system can predict the clinical status including the morphologic findings of the liver, the status of IHD, and the degree of portal hypertension in patients with of biliary atresia following the Kasai Portoenterostomy.

Our Imaging grading system can predict the clinical status of patients with biliary atresia following Kasai portoenterostomy.

Lee, H, Kim, Y, Kim, M, Kwon, J, Imaging Grading System for Long-Term Survivals of Biliary Atresia Following the Kasai Portoenterostomy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12033062.html