Kim et al reported a risk score for predicting biliary atresia in a patient with neonatal cholestasis. The authors are from Asan Medical Center Children's Hospital, University of Ulsan, and Pusan National University Yangsan Hospital in South Korea.
Patient selection: neonatal cholestasis
Parameters:
(1) full term vs preterm birth
(2) triangular cord thickness at ultrasonography in mm (a triangular or tubular echogenic cord of fibrous tissue at the porta hepatis that is the ductal remnant of the extrahepatic bile duct)
(3) gallbladder structure on ultrasound
(4) hepatobiliary scintigraphy findings (failure of radioisotope excretion to small bowel)
Parameter
Finding
Points
term at birth
preterm
0
full term
1
triangular cord thickness
< 3.5 mm
0
>= 3.5 mm
1
gallbladder structure
normal
0
abnormal
2
hepatobiliary scintigraphy
negative for biliary atresia
0
equivocal for biliary atresia
2
positive findings for biliary atresia
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of biliary atresia.
Performance:
• The area under the ROC curve is 0.98.
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