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Sonographic Diagnosis of Biliary Atresia in Pediatric Patients Using the "Triangular Cord" Sign Versus Gallbladder Length and Contraction

Kimio Kanegawa1, Yoshinobu Akasaka1, Eri Kitamura1, Syoji Nishiyama1, Toshihiro Muraji2, Eiji Nishijima2, Shiiki Satoh2 and Chikara Tsugawa2

1 Department of Radiology, Kobe Children's Hospital, 1-1-1 Takakuradai Suma-ku, Kobe 654-0081, Japan.
2 Department of Pediatric Surgery, Kobe Children's Hospital, Kobe 654-0081, Japan.



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  		Fig. 1. —Sonogram illustrates method of measuring gallbladder length (long arrow) and width (short arrow). These measurements were obtained using maximal longitudinal image.

 


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  		Fig. 2. —35-day-old male infant with biliary atresia. Sonogram reveals tubular echogenic cord (arrows).

 


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  		Fig. 3A. —95-day-old female infant with neonatal hepatitis. Sonogram shows normal gallbladder. Gallbladder is 3.1 cm long.

 


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  		Fig. 4A. —64-day-old female infant with biliary atresia. Sonogram shows abnormal gallbladder (arrows). Gallbladder is 1.0 cm long.

 


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  		Fig. 3B. —95-day-old female infant with neonatal hepatitis. Sonogram obtained 1 hr after patient was fed shows gallbladder is contracted. Contraction index was 99.6%.

 


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  		Fig. 4B. —64-day-old female infant with biliary atresia. Sonogram obtained 1 hr after patient was fed shows that gallbladder (arrows) has not contracted. Contraction index was 0%.

 


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  		Fig. 5. —15-day-old female neonate with unknown cause of infantile cholestasis. Sonogram reveals tubular echogenic cord (arrows). "Triangular cord" was 0.3–0.4 cm wide and 1.3–1.6 cm long.

 

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