Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA): A Systematic Review and Meta-Analysis

The early diagnosis of biliary atresia (BA) in cholestatic infants is critical to the success of the treatment. Intraoperative cholangiography (IOC), an invasive imaging technique, is the current strategy for the diagnosis of BA. Ultrasonography has advanced over recent years and emerging techniques...

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Bibliographic Details
Published in:Children (Basel) 2022-10, Vol.9 (11), p.1676
Main Authors: Gunda, Simon Takadiyi, Chambara, Nonhlanhla, Chen, Xiangyan Fiona, Pang, Marco Yiu Chung, Ying, Michael Tin-Cheung
Format: Article
Language:English
Subjects:
Accuracy
Artificial intelligence
Bias
Bile ducts
Biliary atresia
Biopsy
Diagnosis
diagnostic accuracy
diagnostic performance
elastography
Gallbladder
Gallbladder diseases
intraoperative cholangiography (IOC)
Liver
Medical diagnosis
Meta-analysis
Methods
Patients
Pediatrics
Software
Success
Systematic Review
Ultrasonic imaging
ultrasonography
Ultrasound imaging
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Summary:The early diagnosis of biliary atresia (BA) in cholestatic infants is critical to the success of the treatment. Intraoperative cholangiography (IOC), an invasive imaging technique, is the current strategy for the diagnosis of BA. Ultrasonography has advanced over recent years and emerging techniques such as shear wave elastography (SWE) have the potential to improve BA diagnosis. This review sought to evaluate the diagnostic efficacy of advanced ultrasonography techniques in the diagnosis of BA. Six databases (CINAHL, Medline, PubMed, Google Scholar, Web of Science (core collection), and Embase) were searched for studies assessing the diagnostic performance of advanced ultrasonography techniques in differentiating BA from non-BA causes of infantile cholestasis. The meta-analysis was performed using Meta-DiSc 1.4 and Comprehensive Meta-analysis v3 software. Quality Assessment of Diagnostic Accuracy Studies tool version 2 (QUADAS-2) assessed the risk of bias. Fifteen studies consisting of 2185 patients (BA = 1105; non-BA = 1080) met the inclusion criteria. SWE was the only advanced ultrasonography technique reported and had a good pooled diagnostic performance (sensitivity = 83%; specificity = 77%; AUC = 0.896). Liver stiffness indicators were significantly higher in BA compared to non-BA patients (p < 0.000). SWE could be a useful tool in differentiating BA from non-BA causes of infantile cholestasis. Future studies to assess the utility of other advanced ultrasonography techniques are recommended.
ISSN:2227-9067
2227-9067
DOI:10.3390/children9111676