J Korean Assoc Pediatr Surg.  2012 Jun;18(1):12-17. 10.13029/jkaps.2012.18.1.12.

MRI Findings of Long-term Survivals after Kasai Portoenterostomy

• Jung J
• Jung E
• Park WH
• Choi SO

• KMID: 1433779
• DOI: http://doi.org/10.13029/jkaps.2012.18.1.12

Abstract

The purpose of this study is to analyse clinical impact of specific MRI findings in liver in patients of long-term survivors after Kasai portoenterostomy (KPE). Twenty-eight patients who were underwent KPE were followed up more than 5 years. Macro-regenerative nodule (MRN) and beaded-duct dilatation (BDD) were considered as important findings in liver MRI. The association between these findings in MRI and clinical indicator, serum bilirubin level and history of cholangitis were evaluated. Sixteen patients (57.1%) were shown MRN in liver MRI. There were 14 patients(50%) whose MRI showed BDD. Serum total and direct bilirubin were 3.6mg/dL and 1.8mg/dL respectively in positive MRN group whereas 1.4mg/dL and 0.7mg/dL in negative MRN group (p 0.427). Serum total and direct bilirubin level were 4.2mg/dL and 2.1mg/dL in patients with BDD negative group compare to 1.1mg/dL and 0.5mg/dL in BDD positive group (p 0.281). The odds ratio to have cholangitis in the patient with MRN was 2.3 and 0.53 in patient with BDD in their MRI findings. MRN in liver MRI may suggest high bilirubin level and more chance to have cholangitis, but the findings of BDD may related to low bilirubin level and less change to have cholangitis.

Keyword

Biliary atresia; Kasai operation; MRI; Macroregenerative nodule; Beaded duct dilatation

MeSH Terms

Biliary Atresia
Bilirubin
Cholangitis
Dilatation
Dioxoles
Humans
Liver
Odds Ratio
Survivors
Bilirubin
Dioxoles

Figure

• 

  Fig. 1 Findings of macroregenerative nodule and beaded duct appearance in MRI. A. T2-weighted MR image shows isodense nodule-like contour along the margin of the liver. B. Beaded duct dilatation which shows several high-signal small dilatations of biliary duct in T1-weighted MRI (arrows)

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