{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T15:36:53Z","timestamp":1773589013768,"version":"3.50.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T00:00:00Z","timestamp":1517616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81570471"],"award-info":[{"award-number":["81570471"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tianjin Health Bureau special grant","award":["14KG129"],"award-info":[{"award-number":["14KG129"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"published-print":{"date-parts":[[2018,4]]},"DOI":"10.1007\/s00383-018-4229-1","type":"journal-article","created":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T04:45:11Z","timestamp":1517633111000},"page":"363-380","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Early differential diagnosis methods of biliary atresia: a meta-analysis"],"prefix":"10.1007","volume":"34","author":[{"given":"Li","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0803-1114","authenticated-orcid":false,"given":"Jianghua","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2018,2,3]]},"reference":[{"key":"4229_CR1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/00005176-200307000-00003","volume":"37","author":"RJ Sokol","year":"2003","unstructured":"Sokol RJ, Mack C, Narkewicz MR et al (2003) Pathogenesis and outcome of biliary atresia: current concepts. J Pediatr Gastroenterol Nutr 37: 4\u201321","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4229_CR2","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/MPG.0b013e3181633562","volume":"46","author":"BE Wildhaber","year":"2008","unstructured":"Wildhaber BE, Majno P, Mayr J et al (2008) Biliary atresia: Swiss national study, 1994\u20132004. J Pediatr Gastroenterol Nutr 46:299\u2013307","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4229_CR3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","volume":"155","author":"PF Whiting","year":"2011","unstructured":"Whiting PF, Rutjes AW, Westwood ME et al (2011) Quadas-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529\u2013536","journal-title":"Ann Intern Med"},{"key":"4229_CR4","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/S0022-3476(87)80396-7","volume":"110","author":"W Spivak","year":"1987","unstructured":"Spivak W, Sarkar S, Winter D et al (1987) Diagnostic utility of hepatobiliary scintigraphy with 99mtc-disida in neonatal cholestasis. J Pediatr 110: 855\u2013861","journal-title":"J Pediatr"},{"key":"4229_CR5","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1097\/00005176-198601000-00006","volume":"5","author":"V Tolia","year":"1986","unstructured":"Tolia V, Dubois RS, Kagalwalla A, at el (1986) Comparison of radionuclear scintigraphy and liver biopsy in the evaluation of neonatal cholestasis. J Pediatr Gastroenterol Nutr 5:30\u201334","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4229_CR6","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1097\/00005176-198711000-00011","volume":"6","author":"KL Cox","year":"1987","unstructured":"Cox KL, Stadalnik RC, Mcgahan JP et al (1987) Hepatobiliary scintigraphy with technetium-99m disofenin in the evaluation of neonatal cholestasis. J Pediatr Gastroenterol Nutr 6:885\u2013891","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"4229_CR7","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1016\/S0022-3468(97)90451-6","volume":"32","author":"WH Park","year":"1997","unstructured":"Park WH, Choi SO, Lee HJ et al (1997) A new diagnostic approach to biliary atresia with emphasis on the ultrasonographic triangular cord sign: comparison of ultrasonography, hepatobiliary scintigraphy, and liver needle biopsy in the evaluation of infantile cholestasis. J Pediatr Surg 32:1555\u20131559","journal-title":"J Pediatr Surg"},{"key":"4229_CR8","first-page":"1209","volume":"41","author":"CH Lee","year":"2000","unstructured":"Lee CH, Wang P, Lee TT et al (2000) The significance of functioning gallbladder visualization on hepatobiliary scintigraphy in infants with persistent jaundice. J Nucl Med 41:1209\u20131213","journal-title":"J Nucl Med"},{"key":"4229_CR9","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s002470050017","volume":"30","author":"KA Tan","year":"2000","unstructured":"Tan KA, Phua KB, Ooi BC et al (2000) Making the diagnosis of biliary atresia using the triangular cord sign and gallbladder length. Pediatr Radiol 30:69\u201373","journal-title":"Pediatr Radiol"},{"key":"4229_CR10","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1259\/bjr.74.886.740952","volume":"74","author":"P Farrant","year":"2001","unstructured":"Farrant P, Meire HB, Mieli-Vergani G (2001) Improved diagnosis of extraheptic biliary atresia by high frequency ultrasound of the gall bladder. Br J Radiol 74:952\u2013954","journal-title":"Br J Radiol"},{"key":"4229_CR11","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1007\/s00383-010-2814-z","volume":"27","author":"Y Sun","year":"2011","unstructured":"Sun Y, Zheng S, Qian Q (2011) Ultrasonographic evaluation in the differential diagnosis of biliary atresia and infantile hepatitis syndrome. Pediatr Surg Int 27:675\u2013679","journal-title":"Pediatr Surg Int"},{"key":"4229_CR12","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1053\/jpsu.2002.31617","volume":"37","author":"SJ Han","year":"2002","unstructured":"Han SJ, Kim MJ, Han A et al (2002) Magnetic resonance cholangiography for the diagnosis of biliary atresia. J Pediatr Surg 37:599\u2013604","journal-title":"J Pediatr Surg"},{"key":"4229_CR13","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1007\/s00383-003-0962-0","volume":"19","author":"T Azuma","year":"2003","unstructured":"Azuma T, Nakamura T, Nakahira M et al (2003) Pre-operative ultrasonographic diagnosis of biliary atresia\u2014with reference to the presence or absence of the extrahepatic bile duct. Pediatr Surg Int 19:475\u2013477","journal-title":"Pediatr Surg Int"},{"key":"4229_CR14","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1148\/radiol.292020472","volume":"229","author":"HJ Lee","year":"2003","unstructured":"Lee HJ, Lee SM, Park WH et al (2003) Objective criteria of triangular cord sign in biliary atresia on US scans. Radiology 229:395\u2013400","journal-title":"Radiology"},{"key":"4229_CR15","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1046\/j.1440-1673.2003.01172.x","volume":"47","author":"P Visrutaratna","year":"2003","unstructured":"Visrutaratna P, Wongsawasdi L, Lerttumnongtum P et al (2003) Triangular cord sign and ultrasound features of the gall bladder in infants with biliary atresia. Austr Radio 47:252\u2013256","journal-title":"Austr Radio"},{"key":"4229_CR16","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1148\/radiol.2343040028","volume":"235","author":"HK Ryeom","year":"2005","unstructured":"Ryeom HK, Choe BH, Kim JY et al (2005) Biliary atresia: feasibility of mangafodipir trisodium-enhanced MR cholangiography for evaluation. Radiology 235:250\u2013258","journal-title":"Radiology"},{"key":"4229_CR17","doi-asserted-by":"publisher","first-page":"5893","DOI":"10.3748\/wjg.v12.i36.5893","volume":"12","author":"SM Dehghani","year":"2006","unstructured":"Dehghani SM, Haghighat M, Imanieh MH et al (2006) Comparison of different diagnostic methods in infants with cholestasis. World J Gastroenterol 12:5893\u20135896","journal-title":"World J Gastroenterol"},{"key":"4229_CR18","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1007\/s11596-006-0627-z","volume":"26","author":"Y Hu","year":"2006","unstructured":"Hu Y, Huang Z, Xia L (2006) MR cholangiography and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia and infantile hepatitis syndrome. J Huazhong Univ Sci Technol Med Sci 26:725\u2013727","journal-title":"J Huazhong Univ Sci Technol Med Sci"},{"key":"4229_CR19","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1148\/radiol.2443061051","volume":"244","author":"T Humphrey","year":"2007","unstructured":"Humphrey T, Stringer M (2007) Biliary atresia: US diagnosis. Radiology 244:845\u2013851","journal-title":"Radiology"},{"key":"4229_CR20","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1148\/radiol.2452061093","volume":"245","author":"WS Kim","year":"2007","unstructured":"Kim WS, Cheon JE, Youn BJ et al (2007) Hepatic arterial diameter measured with US: adjunct for US diagnosis of biliary atresia. Radiology 245:549\u2013555","journal-title":"Radiology"},{"key":"4229_CR21","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1016\/j.jpedsurg.2007.08.032","volume":"42","author":"S Takamizawa","year":"2007","unstructured":"Takamizawa S, Zaima A, Muraji et al (2007) Can biliary atresia be diagnosed by ultrasonography alone? J Pediatr Surg 42:2093\u20132096","journal-title":"J Pediatr Surg"},{"key":"4229_CR22","first-page":"345","volume":"91","author":"L Wongsawasdi","year":"2008","unstructured":"Wongsawasdi L, Ukarapol N, Visrutaratna P et al (2008) Diagnostic evaluation of infantile cholestasis. J Med Assoc Thai 91:345\u2013349","journal-title":"J Med Assoc Thai"},{"key":"4229_CR23","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1148\/radiol.2522080923","volume":"252","author":"MS Lee","year":"2009","unstructured":"Lee MS, Kim MJ, Lee MJ et al (2009) Biliary atresia: color doppler US findings in neonates and infants. Radiology 252:282\u2013289","journal-title":"Radiology"},{"key":"4229_CR24","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1111\/j.1651-2227.2009.01338.x","volume":"98","author":"U Poddar","year":"2009","unstructured":"Poddar U, Thapa BR, Das A et al (2009) Neonatal cholestasis: differentiation of biliary atresia from neonatal hepatitis in a developing country. Acta Paediatr 98:1260\u20131264","journal-title":"Acta Paediatr"},{"key":"4229_CR25","first-page":"425","volume":"11","author":"M Rouzrokh","year":"2009","unstructured":"Rouzrokh M, Sobhiyeh MR, Heibatollahi M (2009) The sensitvity, specificity, positive and negative predictive values of stool color test, triangular cord sign and hepatobiliary scintigraphy in diagnosis of infantile biliary atresia. Iran Red Crescent Med J 11:425\u2013430","journal-title":"Iran Red Crescent Med J"},{"key":"4229_CR26","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.clinimag.2009.01.003","volume":"33","author":"JG Yang","year":"2009","unstructured":"Yang JG, Ma DQ, Peng Y et al (2009) Comparison of different diagnostic methods for differentiating biliary atresia from idiopathic neonatal hepatitis. Clin Imaging 33:439\u2013446","journal-title":"Clin Imaging"},{"key":"4229_CR27","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s11684-010-0099-1","volume":"4","author":"SX Liu","year":"2010","unstructured":"Liu SX, Huang ZH (2010) The value of radionuclide hepatobiliary scintigraphy in combination with determination of bilirubin from duodenal drainage in differential diagnosis of infantile persistent jaundice. Front Med China 4:342\u2013345","journal-title":"Front Med China"},{"key":"4229_CR28","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1007\/s00247-011-2019-1","volume":"41","author":"S Aziz","year":"2011","unstructured":"Aziz S, Wild Y, Rosenthal P et al (2011) Pseudo gallbladder sign in biliary atresia\u2014an imaging pitfall. Pediatr Radiol 41:620\u2013626","journal-title":"Pediatr Radiol"},{"key":"4229_CR29","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s00247-011-2202-4","volume":"42","author":"MK Jensen","year":"2012","unstructured":"Jensen MK, Biank VF, Moe DC et al (2012) HIDA, percutaneous transhepatic cholecysto-cholangiography and liver biopsy in infants with persistent jaundice: can a combination of ptcc and liver biopsy reduce unnecessary laparotomy? Pediatr Radiol 42:32\u201339","journal-title":"Pediatr Radiol"},{"key":"4229_CR30","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1111\/jgh.12151","volume":"28","author":"MA Elguindi","year":"2013","unstructured":"Elguindi MA, Sira MM, Konsowa HA et al (2013) Value of hepatic subcapsular flow by color doppler ultrasonography in the diagnosis of biliary atresia. J Gastroenterol Hepatol 28:867\u2013872","journal-title":"J Gastroenterol Hepatol"},{"key":"4229_CR31","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/S1499-3872(13)60065-X","volume":"12","author":"LP Jiang","year":"2013","unstructured":"Jiang LP, Chen YC, Ding L et al (2013) The diagnostic value of high-frequency ultrasonography in biliary atresia. Hepatobiliary Pancreat Dis Int 12:415\u2013422","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"4229_CR32","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1007\/s00247-013-2704-3","volume":"43","author":"N Kwatra","year":"2013","unstructured":"Kwatra N, Shalabyrana E, Narayanan S et al (2013) Phenobarbital-enhanced hepatobiliary scintigraphy in the diagnosis of biliary atresia: two decades of experience at a tertiary center. Pediatr Radiol 43:1365\u20131375","journal-title":"Pediatr Radiol"},{"key":"4229_CR33","doi-asserted-by":"publisher","first-page":"170","DOI":"10.5152\/tjg.2014.5603","volume":"25","author":"A Boskovic","year":"2014","unstructured":"Boskovic A, Kitic I, Prokic D et al (2014) Predictive value of hepatic ultrasound, liver biopsy, and duodenal tube test in the diagnosis of extrahepatic biliary atresia in serbian infants. Turk J Gastroenterol 25:170\u2013174","journal-title":"Turk J Gastroenterol"},{"key":"4229_CR34","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jhep.2014.03.016","volume":"61","author":"MA El-Guindi","year":"2014","unstructured":"El-Guindi MA, Sira MM, Sira AM et al (2014) Design and validation of a diagnostic score for biliary atresia. J Hepatol 61:116\u2013123","journal-title":"J Hepatol"},{"key":"4229_CR35","doi-asserted-by":"publisher","first-page":"e88268","DOI":"10.1371\/journal.pone.0088268","volume":"9","author":"B Liu","year":"2014","unstructured":"Liu B, Cai J, Xu Y et al (2014) Three-dimensional magnetic resonance cholangiopancreatography for the diagnosis of biliary atresia in infants and neonates. Plos One 9:e88268","journal-title":"Plos One"},{"key":"4229_CR36","doi-asserted-by":"publisher","first-page":"3862","DOI":"10.4238\/2015.April.22.15","volume":"14","author":"YX Guan","year":"2015","unstructured":"Guan YX, Chen Q, Wan SH et al (2015) Effect of different time phases of radionuclide hepatobiliary scintigraphy on the differential diagnosis of congenital biliary atresia. Genet Mol Res 14:3862\u20133868","journal-title":"Genet Mol Res"},{"key":"4229_CR37","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.jpedsurg.2014.08.014","volume":"50","author":"T Jancelewicz","year":"2015","unstructured":"Jancelewicz T, Barmherzig R, Chung CT et al (2015) A screening algorithm for the efficient exclusion of biliary atresia in infants with cholestatic jaundice. J Pediatr Surg 50:363\u2013370","journal-title":"J Pediatr Surg"},{"key":"4229_CR38","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.3348\/kjr.2015.16.6.1364","volume":"16","author":"SM Lee","year":"2015","unstructured":"Lee SM, Cheon JE, Choi YH et al (2015) Ultrasonographic diagnosis of biliary atresia based on a decision-making tree model. Korean J Radiol 16:1364\u20131372","journal-title":"Korean J Radiol"},{"key":"4229_CR39","first-page":"A5253","volume":"63","author":"JM Brittain","year":"2016","unstructured":"Brittain JM, Kvist N, Johansen LS et al (2016) Hepatobiliary scintigraphy for early diagnosis of biliary atresia. Dan Med J 63:A5253","journal-title":"Dan Med J"},{"key":"4229_CR40","doi-asserted-by":"publisher","first-page":"63","DOI":"10.4103\/0189-6725.182558","volume":"13","author":"R Mandana","year":"2016","unstructured":"Mandana R, Lida S, Shoa HJ et al (2016) Diagnostic value of anti-smooth muscle antibodies and liver enzymes in differentiation of extrahepatic biliary atresia and idiopathic neonatal hepatitis. Afr J Paediatr Surg 13:63\u201368","journal-title":"Afr J Paediatr Surg"},{"key":"4229_CR41","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1016\/j.jpedsurg.2016.09.044","volume":"51","author":"Z Shen","year":"2016","unstructured":"Shen Z, Zheng S, Dong R et al (2016) Saturation of stool color in HSV color model is a promising objective parameter for screening biliary atresia. J Pediatr Surg 51:2091\u20132094","journal-title":"J Pediatr Surg"},{"key":"4229_CR42","doi-asserted-by":"publisher","first-page":"37","DOI":"10.5152\/tjg.2015.150379","volume":"27","author":"T\u00fcmg\u00f6r\u2002G A\u011f\u0131n\u2002M","year":"2016","unstructured":"A\u011f\u0131n\u2002M T\u00fcmg\u00f6r\u2002G, Alkan M et al (2016) Clues to the diagnosis of biliary atresia in neonatal cholestasis. Turk J Gastroenterol 27:37\u201341","journal-title":"Turk J Gastroenterol"},{"key":"4229_CR43","doi-asserted-by":"publisher","first-page":"e0158132","DOI":"10.1371\/journal.pone.0158132","volume":"11","author":"S Sung","year":"2016","unstructured":"Sung S, Jeon TY, Yoo SY et al (2016) Incremental value of MR cholangiopancreatography in diagnosis of biliary atresia. Plos One 11:e0158132","journal-title":"Plos One"},{"key":"4229_CR44","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/00005176-200408000-00001","volume":"39","author":"V Moyer","year":"2004","unstructured":"Moyer V, Freese DK, Whitington PF et al (2004) Guideline for the evaluation of cholestatic jaundice in infants: recommendations of the North American Society for pediatric gastroenterology, hepatology and nutrition. J Pediatr Gastroenterol Nutr 39:115\u2013128","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00383-018-4229-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-018-4229-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-018-4229-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,2,2]],"date-time":"2019-02-02T20:04:00Z","timestamp":1549137840000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00383-018-4229-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,3]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["4229"],"URL":"https:\/\/doi.org\/10.1007\/s00383-018-4229-1","relation":{},"ISSN":["0179-0358","1437-9813"],"issn-type":[{"value":"0179-0358","type":"print"},{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,3]]},"assertion":[{"value":"11 January 2018","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2018","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}}]}}