Abstract
This article explores the optimization of ultrasound (US) diagnostic methods and the refinement of diagnostic algorithms for the early detection of biliary atresia (BA) in neonates. The relevance of the study is driven by the complexities of differential diagnosis between BA and neonatal hepatitis, as well as the fact that the success of surgical intervention (Kasai procedure) directly depends on the timing of the diagnosis. The paper proposes an updated diagnostic approach based on a comprehensive analysis of the "triangular cord sign," gallbladder morphometry, and Dopplerometric indicators of hepatic hemodynamics. The proposed algorithm allows for the reduction of diagnostic errors and optimizes the pre-operative period for improved clinical outcomes.
References
1. Davenport M. Biliary atresia: From description to strategy. Journal of Pediatric Surgery. 2016; 51(3): 346-355.
2. Choi S.O., Park W.H., Lee H.J., Woo S.K. "Triangular cord": a helpful ultrasonographic finding in the diagnosis of biliary atresia. Journal of Pediatric Surgery. 1996; 31(3): 399-401. (Klassik manba).
3. Lee H.J., Lee S.Y., Itoh S. Ultrasonography of biliary atresia: focus on the triangular cord sign. Ultrasonography. 2009; 28(2): 71-77.
4. Kanegawa K., Akasaka Y., Kitamura E. et al. Sonographic diagnosis of biliary atresia in pediatric patients using the "triangular cord" sign versus gallbladder length and shape. American Journal of Roentgenology. 2003; 181(5): 1387-1390.
5. Zhou L.Y., Wang W., Lin M. et al. Optimization of Ultrasound Diagnosis of Biliary Atresia in Infants: A Multi-center Study. Scientific Reports. 2015; 5: 110-115.
6. Galina P., Alexopoulou E., Mentessidou A. et al. Diagnostic accuracy of two-dimensional shear wave elastography in the diagnosis of biliary atresia. European Radiology. 2021; 31(11): 8391-8401.
7. Mizuno M., Nakamura H., Koga H. et al. New ultrasound score for the diagnosis of biliary atresia: A retrospective study. Pediatrics International. 2017; 59(6): 694-700.
8. Hussain S.Z., Alshuraafa A., Arshad S. et al. Biliary Atresia: Global Perspectives of Care. Journal of Pediatric Gastroenterology and Nutrition. 2021; 72(4): 492-498.
9. Vajro P., Ferrante L., Paolella G. Challenges in the early diagnosis of biliary atresia. World Journal of Gastroenterology. 2020; 26(47): 7432-7445.
10. Zeng J., Wu S., Sun L. et al. The value of the gallbladder contractility in the diagnosis of biliary atresia. Journal of Medical Ultrasound. 2019; 27(3): 123-127.
11. Razumovskiy A.Yu., Dekabrev A.S., Smirnov A.N. Biliarnaya atreziya: sovremennaya taktika xirurgicheskogo lecheniya. Voprosi sovremennoy pediatrii. 2018; 17(2): 112-118. (Rus tilida).
12. Sokolov Yu.Yu., Donskoy D.V., Vilesov A.V. i dr. Diagnostika i lecheniye xolestaticheskix zabolevaniy pecheni u detey rannego vozrasta. Detskaya xirurgiya. 2019; 23(1): 45-51.
13. Pivovarova N.V., Gumerov A.A., Amirova A.A. Ul'trazvukovaya diagnostika anomaliy jeltchevivodyashix putey u novorojdennyx. Ul'trazvukovaya i funksional'naya diagnostika. 2020; 4: 56-62.
14. Yusupov Sh.A., Shamsiyev A.M., Atakulov J.O. Bolalarda jigar va o‘t yo‘llari xirurgik kasalliklari diagnostikasi. Pediatriya. Toshkent, 2021; 2: 12-18. (O‘zbek tilida).
15. Aliev M.M., Turaeva N.N. Chaqaloqlarda neonatal xolestazning differensial diagnostikasi. O‘zbekiston xirurgiyasi. 2022; 1: 34-40.