MRI Findings of Long-term Survivals after Kasai Portoenterostomy

JiKwang Jung; Eunyoung Jung; Woo-Hyun Park; Soon-Ok Choi

doi:10.0000/jkaps.2012.18.1.12

Journal List > J Korean Assoc Pediatr Surg > v.18(1) > 1015909

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Jung, Jung, Park, and Choi: MRI Findings of Long-term Survivals after Kasai Portoenterostomy

Original Article

Journal of the Korean Association of Pediatric Surgeons

Journal of the Korean Association of Pediatric Surgeons 2012; 18(1): 12-17.

Published online: 30 June 2012

DOI: https://doi.org/10.0000/jkaps.2012.18.1.12

MRI Findings of Long-term Survivals after Kasai Portoenterostomy

JiKwang Jung, M.D., Eunyoung Jung, M.D., Woo-Hyun Park, M.D., Soon-Ok Choi, M.D.

Department of Pediatric Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Correspondence: Soon-Ok Choi, M.D., Dongsan Medical Center, Keimyung University School of Medicine, 194 Dongsan-dong, Jungu, Daegu 700-712, Korea. Tel: 053)250-7323, Fax: 053)250-7322, choi1635@dsmc.or.kr

Received 14 June 2012 Accepted 10 October 2012

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.

Keywords: Biliary atresia, Kasai operation, MRI, Macroregenerative nodule, Beaded duct dilatation

Figures and Tables

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)

Table 1

Summary of the Long-term Survivors Who Were Taken MRI Scan.

Table 2

Serum Total Bilirubin and Direct Bilirubin Level (mg/dL) according to the MRI Findings of the Patients of Long-term Survivors after Kasai Procedure.

Table 3

The Number of Patients Which Shows Early History of Cholangitis and MRN/BDD in MRI Findings.

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