Multidetector computed tomography hepatic findings in children with end-stage biliary atresia.

Abstract

To illustrate the multidetector computed tomography (MDCT) findings in patients with end-stage biliary atresia (BA). The study group consists of 45 consecutive patients with BA who underwent MDCT before liver transplantation from February 2005 to February 2008. Mean age was 36 months, 24 patients were female, and 22 had undergone a previous Kasai procedure. MDCT detected a total of 15 hepatocellular nodules in 7 patients. Intrahepatic biliary cysts were detected in 14 patients and were significantly associated with a Kasai procedure. Intrahepatic porto-systemic shunts were found in 14 patients (31%), intrahepatic communicating vessels between hepatic veins were found in 24 patients (53%). Anatomical variants of hepatic artery were detected in 21 patients. Seven patients (15%) had portal vein thrombosis; in 12 cases (26%) portal vein diameter was 3 mm or less. MDCT can provide accurate morphological and vascular assessment of patients with end-stage biliary atresia and should be used for precise surgical planning. To the best of our knowledge this is one of the first studies to show the presence of numerous veno-venous communications in BA.