Diagnostic value of MDCT combined with MRCP in biliary obstructive diseases in infants and toddlers

Abstract

Abstract: Objective To explore the diagnostic value of Multidetector CT (MDCT) combined with Magnetic Resonance Cholangiopancreatography (MRCP) in biliary obstructive diseases in infants and toddlers.Methods A retrospective study was conducted on children with biliary obstructive diseases admitted to Children's Hospital Affiliated to Soochow University from January 2021 to January 2024. All cases were confirmed by cholangiography and postoperative pathology. Forty-seven patients with cystic biliary atresia (CBA) were assigned to the CBA group, and 42 patients with choledochal cysts (CC) were assigned to the CC group. The preoperative MDCT and MRCP findings were compared between the two groups, and the diagnostic performance was evaluated using ROC curves.Results In the CBA group, the proportion of children with clay-like stools was 21.28% (10/47), significantly higher than the 0.0% in the CC group. The total bilirubin level in the CBA group was (135.78±22.36) μmol/L, higher than the (95.02±13.15) μmol/L in the CC group, with a statistically significant difference (P<0.05). Imaging examination showed that 72.34% (34/47) of the CBA group had abnormal gallbladder shape, higher than the 26.19% (11/42) in the CC group. In contrast, in the CC group, the proportions of children with intrahepatic bile duct dilation and cystic bile sludge deposition were 38.09% (16/42) and 47.62% (20/42), both of which were higher than those in the CBA group. Additionally, the cyst length and width ratios in the CC group were greater than those in the CBA group (P<0.05). The diagnostic accuracy, sensitivity, and specificity of MDCT were 71.91%, 74.47%, and 69.05%, respectively; for MRCP, these were 83.15%, 85.11%, and 80.95%; and for the combined approach, the figures were 94.38%, 95.74%, and 92.86%, indicating that the combined test was superior to individual tests.Conclusion The combined application of MDCT and MRCP can improve the diagnostic accuracy of biliary obstruction in infants and young children.

Key words: Multidetector CT, Magnetic Resonance Cholangiopancreatography, Choledochal Cyst, Cystic Biliary Atresia

FENG Wei, WANG Zhao-qing. Diagnostic value of MDCT combined with MRCP in biliary obstructive diseases in infants and toddlers[J]. Chinese Hepatolgy, 2025, 30(3): 391-394.

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