Djalilah, Gina Noor and Widayanti, Reny and Setyoboedi, Bagus and Arief, Sjamsul
(2019)
Magnetic resonance cholangiopancreatography as a diagnostic tools to diagnose biliary atresia at Dr.Soetomo hospital.
Magnetic resonance cholangiopancreatography as a diagnostic tools to diagnose biliary atresia at Dr.Soetomo hospital, 03 (2).
pp. 137-142.
ISSN 254-2272
Abstract
Background: Cholestatic jaundice results from diminished bile flow and/or excretion, and can be caused by a number of disorders such as biliary atresia (BA). Magnetic resonance cholangiopancreatography (MRCP) is widely accepted as one of modalities for biliary system imaging, but liver biopsy still generally used for BA diagnosis, especially in developing countries.
Objective: To evaluate diagnostic value of biliary atresia from MRCP to the result of liver biopsy.
Methods: A cross sectional for diagnostic study documented of hospitalized patients from June 2014 to June 2015. All patients were had MRCP and liver biopsy examination. Data of age, gender, clinical manifestation and result of MRCP and liver biopsy with ROC to evaluate the sensitivity and specificity was done. Liver biopsy revealed of billiary atresia was made based on proliferation, degeneration and fibrosis of bile ducts. ROC to evaluate the sensitivity and specificity was done. The sensitivity, specificity, negative predictive value, positive predictive value of MRCP in diagnosing BA were calculated.
Results: There were 16 patients enrolled in this study with median age of diagnose was 6(range 3-11) months old. There were 9/16 girl. The median age of onset of jaundice was 5(range 2-14) days. All patients had hepatomegaly and splenomegaly. Histopathology from liver biopsy revealed biliary atresia in 12/16 patients. From ROC curve, sensitivity of MRCP was 87.5% and specificity 62.5% with PPV 70% and NPV 80%. Five patients underwent of Kasai procedure and revealed biliary atresia.
Conclusion: MRCP is sensitive but not specific for diagnosing BA and MRCP has moderate sensitivity and specificity for BA diagnosis.
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