Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Diagnostic Imaging of Biliary Atresia

담도폐쇄증의 영상 진단

  • Haesung Yoon (Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Hyun Ji Lim (Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Jisoo Kim (Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Mi-Jung Lee (Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine)
  • 윤혜성 (연세대학교 의과대학 세브란스 어린이병원 영상의학과, 방사선의과학연구소) ;
  • 임현지 (연세대학교 의과대학 세브란스 어린이병원 영상의학과, 방사선의과학연구소) ;
  • 김지수 (연세대학교 의과대학 세브란스 어린이병원 영상의학과, 방사선의과학연구소) ;
  • 이미정 (연세대학교 의과대학 세브란스 어린이병원 영상의학과, 방사선의과학연구소)
  • Received : 2022.05.23
  • Accepted : 2022.09.13
  • Published : 2022.09.01
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Abstract

Biliary atresia is a rare but significant cause of neonatal cholestasis. An early and accurate diagnosis is important for proper management and prognosis. To diagnose biliary atresia, various imaging studies using ultrasonography, MRI, hepatobiliary scans, and cholangiography can be performed, although ultrasonography is more important for initial imaging studies. In this article, we review the findings of biliary atresia from various imaging modalities, including ultrasonography, MRI, hepatobiliary scans, and cholangiography. The known key imaging features include abnormal gallbladder size and shape, periportal thickening visible as a 'triangular cord' sign, invisible common bile duct, increased hepatic arterial flow, and combined anomalies. Aside from the imaging findings of biliary atresia, we also reviewed the diagnostic difficulty in the early neonatal period and the role of imaging in predicting hepatic fibrosis. We hope that this review will aid in the diagnosis of biliary atresia.

담도폐쇄증은 신생아 담즙 정체의 드물지만 중요한 원인이다. 적절한 치료와 예후를 위해서는 정확한 조기 진단이 중요하다. 본 종설에서는 초음파 검사, MRI, 간담도 핵의학스캔, 담관조영술 등의 영상 검사에서 담도폐쇄증의 영상 소견을 검토하였다. 지금까지 알려진 주요 영상의학적 소견들은 담낭의 비정상적인 모양과 크기, 간문맥 주변의 비후를 나타내는 'triangular cord' sign, 총담관이 보이지 않고, 간동맥 혈류가 증가하는 소견 등과 함께 동반된 기형의 유무들을 보이는 것이다. 담도폐쇄증의 진단을 위해 초음파 검사, MRI, 간담도 핵의학 스캔, 담관조영술 등의 여러 영상 검사들을 시행하며, 1차 영상 검사로 초음파 검사가 중요하다. 본 종설에서는 각 영상 검사들에서 지금까지 알려진 담도폐쇄증의 소견들과 함께 조기 신생아기에서 담도폐쇄증 진단의 어려움, 그리고 간 섬유화를 예측하기 위한 영상의 역할도 검토하였다. 본 종설이 담도폐쇄증 진단에 도움이 되길 바란다.

Keywords

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