{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:31:10Z","timestamp":1788406270101,"version":"build-2803163510"},"reference-count":61,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T00:00:00Z","timestamp":1495843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the diagnostic performance of sonographic features of biliary atresia in patients with infantile cholestasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Ovid\u2010MEDLINE and EMBASE databases were searched for studies of the diagnostic performance of sonographic features of biliary atresia in patients with infantile cholestasis. A meta\u2010analysis was performed to evaluate the diagnostic performance of the triangular cord sign and other sonographic features in patients with biliary atresia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen eligible studies with 1444 patients were included. The triangular cord sign had high accuracy for diagnosing biliary atresia: the meta\u2010analytic summary sensitivity and specificity were 85% (95% confidence interval, 77%\u201390%) and 97% (95% confidence interval, 94%\u201399%), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.97. Meta\u2010regression analysis revealed that the cutoff thickness of the triangular cord sign (3 or 4\u2009mm) was a significant factor affecting study heterogeneity (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). The proportions of nonidentification of the gallbladder (GB) ranged from 0% to 53%. Abnormal GB morphologic characteristics, nonvisualization of the common bile duct, and the presence of hepatic subcapsular flow showed relatively high sensitivities and specificities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The triangular cord sign and other sonographic features, including abnormal GB morphologic characteristics, nonvisualization of the common bile duct, and the presence of hepatic subcapsular flow, had high diagnostic performance for the diagnosis of biliary atresia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.14234","type":"journal-article","created":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T06:36:49Z","timestamp":1495867009000},"page":"2027-2038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Diagnostic Performance of Sonographic Features in Patients With Biliary Atresia: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"36","author":[{"given":"Hee Mang","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology University of Ulsan College of Medicine, Asan Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Hyun","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiology, Namwon Medical Center Namwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Rye","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology University of Ulsan College of Medicine, Asan Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Seong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology University of Ulsan College of Medicine, Asan Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ah Young","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology University of Ulsan College of Medicine, Asan Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Ah","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology University of Ulsan College of Medicine, Asan Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,27]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"113","article-title":"Considerations of the pathogenesis of neonatal hepatitis, biliary atresia and choledochal cyst: the concept of infantile obstructive cholangiopathy","volume":"6","author":"Landing BH","year":"1974","journal-title":"Prog Pediatr Surg"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01556048"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60946-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(97)90451-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.215.2.r00ma04395"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.2.416"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.292020472"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-003-0867-z"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2343040028"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2443061051"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2452061093"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.08.032"},{"key":"e_1_2_6_14_1","first-page":"345","article-title":"Diagnostic evaluation of infantile cholestasis","volume":"91","author":"Wongsawasdi L","year":"2008","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2522080923"},{"key":"e_1_2_6_16_1","first-page":"425","article-title":"The sensitivity, specificity, positive and negative predictive values of stool color test, triangular cord sign and hepatobiliary scintigraphy in diagnosis of infantile biliary atresia","volume":"11","author":"Rouzrokh M","year":"2009","journal-title":"Iran Red Crescent Med J"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0718-3"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1499-3872(13)60065-X"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.03.016"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.6.1364"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142309"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(96)90739-3"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1071111"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-25"},{"key":"e_1_2_6_25_1","unstructured":"HigginsJ GreenS.Cochrane Handbook for Systematic Reviews of Interventions: Version 5.1.0. The Cochrane Collaboration website.http:\/\/handbook.cochrane.org\/. Accessed August 15 2015."},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2016.17.1.5"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.6.1175"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.6.1188"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-2-9"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.01.016"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-003-0962-0"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(03)00498-6"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2003.12.014"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/147323001003800626"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.73.875.11144791"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.74.886.740952"},{"key":"e_1_2_6_37_1","first-page":"175","article-title":"Differential diagnosis of infantile choledochal cyst with or without biliary atresia","volume":"47","author":"Huang FC","year":"2006","journal-title":"Acta Paediatr Taiwan"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199904000-00012"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.209.2.9807575"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/34728497"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-006-0117-8"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2009.01.003"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.07.058"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1673.2003.01172.x"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12151"},{"key":"e_1_2_6_46_1","first-page":"S275","article-title":"Impact of specialised ultrasound examination on the investigation of infants with neonatal cholestasis [abstract]","volume":"41","author":"Humphrey T","year":"2011","journal-title":"Pediatr Radiol"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.181.5.1811387"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.14366\/usg.14016"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90650-4"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005340170005"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050017"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2012.31.6.833"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i36.5893"},{"key":"e_1_2_6_54_1","first-page":"30","article-title":"Sonographic evaluation of the triangular cord sign in the diagnosis of biliary atresia, confirmed with needle liver biopsy","volume":"31","author":"Rehman S","year":"2007","journal-title":"Pak Pediatr J"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.3579"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.3923\/pjbs.2009.95.97"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1335455"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2814-z"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.5180"},{"key":"e_1_2_6_60_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.2223\/JPED.1811","article-title":"Accuracy of echogenic periportal enlargement image in ultrasonographic exams and histopathology in differential diagnosis of biliary atresia","volume":"84","author":"Roquete ML","year":"2008","journal-title":"J Pediatr"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_6_62_1","volume-title":"Handbook for Diagnostic Test Accuracy Reviews","author":"Cochrane Methods: Screening and Diagnostic Tests"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjum.14234","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.14234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T06:51:54Z","timestamp":1694674314000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.14234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,27]]},"references-count":61,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1002\/jum.14234"],"URL":"https:\/\/doi.org\/10.1002\/jum.14234","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,27]]},"assertion":[{"value":"2016-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}