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Abstract：
OBJECTIVE: To evaluate the usefulness of porta hepatis lymph nodes (PHLNs) on ultrasonography (US) scans in diagnosing biliary atresia (BA) and predicting the outcomes after Kasai portoenterostomy (KPE) surgery.
METHODS: A total of 668 patients from one hospital were enrolled in the study (542 non-BA and 126 BA). The independent and combined diagnostic efficacy of PHLNs, triangular cord (TC) thickness, and gallbladder morphology were assessed by drawing the receiver operating characteristic (ROC) curves and counting the area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The US features, histopathological findings of PHLNs, and serum total bilirubin (TBIL) levels 3 months post-KPE were correlated.
RESULTS: The AUC, sensitivity, specificity, PPV, and NPV of PHLNs with hyperechogenicity and a maximum length larger than 8.4 mm were 0.898, 81.8%, 97.8%, 89.6%, and 95.8%, respectively. The combination of PHLNs, TC thickness, and gallbladder morphology achieved the best overall diagnostic efficacy among all indicators with an AUC of 0.927 and a sensitivity of 99.2%. The germinal center number and bile particle number of PHLNs were positively correlated with pathological size and US echogenicity intensity of PHLNs, respectively (r = 0.591, 0.377, p = 0.001, 0.004). The pathological size of PHLNs in BA patients was negatively correlated with jaundice clearance status 3 months after KPE surgery (r = -0.385, p = 0.047).
CONCLUSIONS: PHLNs with hyperechogenicity and a maximum length > 8.4 mm are useful US indicators for BA diagnosis. Additionally, the enlargement of PHLNs might play a role in predicting outcomes of KPE surgery.
UNASSIGNED: The article proposed for the first time that PHLNs with hyperechogenicity and a maximum length > 8.4 mm are a useful US indicator for diagnosing BA.
CONCLUSIONS: PHLNs may be helpful in diagnosing BA and predicting outcomes after surgery. Enlarged hyperechoic PHLNs are a useful diagnostic indicator for BA, and play a role in predicting surgical outcomes. These findings can assist clinicians in more accurately diagnosing BA, enabling more timely treatments.
METHODS: A total of 668 patients from one hospital were enrolled in the study (542 non-BA and 126 BA). The independent and combined diagnostic efficacy of PHLNs, triangular cord (TC) thickness, and gallbladder morphology were assessed by drawing the receiver operating characteristic (ROC) curves and counting the area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The US features, histopathological findings of PHLNs, and serum total bilirubin (TBIL) levels 3 months post-KPE were correlated.
RESULTS: The AUC, sensitivity, specificity, PPV, and NPV of PHLNs with hyperechogenicity and a maximum length larger than 8.4 mm were 0.898, 81.8%, 97.8%, 89.6%, and 95.8%, respectively. The combination of PHLNs, TC thickness, and gallbladder morphology achieved the best overall diagnostic efficacy among all indicators with an AUC of 0.927 and a sensitivity of 99.2%. The germinal center number and bile particle number of PHLNs were positively correlated with pathological size and US echogenicity intensity of PHLNs, respectively (r = 0.591, 0.377, p = 0.001, 0.004). The pathological size of PHLNs in BA patients was negatively correlated with jaundice clearance status 3 months after KPE surgery (r = -0.385, p = 0.047).
CONCLUSIONS: PHLNs with hyperechogenicity and a maximum length > 8.4 mm are useful US indicators for BA diagnosis. Additionally, the enlargement of PHLNs might play a role in predicting outcomes of KPE surgery.
UNASSIGNED: The article proposed for the first time that PHLNs with hyperechogenicity and a maximum length > 8.4 mm are a useful US indicator for diagnosing BA.
CONCLUSIONS: PHLNs may be helpful in diagnosing BA and predicting outcomes after surgery. Enlarged hyperechoic PHLNs are a useful diagnostic indicator for BA, and play a role in predicting surgical outcomes. These findings can assist clinicians in more accurately diagnosing BA, enabling more timely treatments.
摘要：
目的：评估肝门淋巴结（PHLNs）在超声（US）扫描中诊断胆道闭锁（BA）和预测Kasai门肠造口术（KPE）术后结局的有用性。
方法：一家医院共668名患者纳入研究（542名非BA和126BA）。PHLN的独立和联合诊断效能，三角线（TC）厚度，通过绘制受试者工作特征（ROC）曲线并计数ROC曲线下面积（AUC）来评估胆囊形态，灵敏度,特异性，阳性预测值(PPV)，和阴性预测值(NPV)。美国的特点,PHLNs的组织病理学发现，与KPE后3个月血清总胆红素（TBIL）水平相关。
结果：AUC，灵敏度,特异性，PPV,具有高回声性和最大长度大于8.4mm的PHLN的NPV分别为0.898，81.8％，97.8%,89.6%,和95.8%，分别。PHLN的组合，TC厚度,胆囊形态学在所有指标中取得了最佳的总体诊断效能，AUC为0.927，灵敏度为99.2%。PHLN的生发中心数和胆汁颗粒数与PHLN的病理大小和US回声强度呈正相关。（r=0.591，0.377，p=0.001，0.004）。BA患者术后3个月的PHLN病理大小与黄疸清除状态呈负相关(r=-0.385,p=0.047)。
结论：具有高回声性和最大长度>8.4mm的PHLN是用于BA诊断的有用的US指标。此外,PHLN的扩大可能在预测KPE手术结局方面发挥作用.
■文章首次提出了具有高回声性和最大长度>8.4mm的PHLN是诊断BA的有用的美国指标。
结论：PHLNs可能有助于诊断BA和预测术后结局。扩大的高回声PHLN是BA的有用诊断指标，并在预测手术结果方面发挥作用。这些发现可以帮助临床医生更准确地诊断BA，使更及时的治疗。
方法：一家医院共668名患者纳入研究（542名非BA和126BA）。PHLN的独立和联合诊断效能，三角线（TC）厚度，通过绘制受试者工作特征（ROC）曲线并计数ROC曲线下面积（AUC）来评估胆囊形态，灵敏度,特异性，阳性预测值(PPV)，和阴性预测值(NPV)。美国的特点,PHLNs的组织病理学发现，与KPE后3个月血清总胆红素（TBIL）水平相关。
结果：AUC，灵敏度,特异性，PPV,具有高回声性和最大长度大于8.4mm的PHLN的NPV分别为0.898，81.8％，97.8%,89.6%,和95.8%，分别。PHLN的组合，TC厚度,胆囊形态学在所有指标中取得了最佳的总体诊断效能，AUC为0.927，灵敏度为99.2%。PHLN的生发中心数和胆汁颗粒数与PHLN的病理大小和US回声强度呈正相关。（r=0.591，0.377，p=0.001，0.004）。BA患者术后3个月的PHLN病理大小与黄疸清除状态呈负相关(r=-0.385,p=0.047)。
结论：具有高回声性和最大长度>8.4mm的PHLN是用于BA诊断的有用的US指标。此外,PHLN的扩大可能在预测KPE手术结局方面发挥作用.
■文章首次提出了具有高回声性和最大长度>8.4mm的PHLN是诊断BA的有用的美国指标。
结论：PHLNs可能有助于诊断BA和预测术后结局。扩大的高回声PHLN是BA的有用诊断指标，并在预测手术结果方面发挥作用。这些发现可以帮助临床医生更准确地诊断BA，使更及时的治疗。
