To evaluate the value of color Doppler ultrasonography in the diagnosis of liver cirrhosis in infants with biliary atresia (BA), and to identify the reliable ultrasound parameters on morphology and hemodynamics.

From January 2014 to April 2017, 93 BA infants who underwent intraoperative cholangilgraphy and liver biopsy or intraoperative cholangilgraphy, Kasai procedure and liver biopsy in the Women and Children′s Medical Center of Guangzhou were retrospectively analyzed. The hepatic fibrosis was graded using Ohkuma′s grading criteria, by which the total of 93 BA patients were divided into the cirrhosis group (grade4) and the non-cirrhosis group (grade0~grade3) according to the results of pathological examination. The preoperative ultrasound data including echotexture of hepatic parenchyma, liver edge, hepatic capsule, splenic diameter, diameter of hepatic artery (HAD), maximum velocity of hepatic artery (HAVmax), resistance index of hepatic artery (HARI), diameter of portal vein (PVD), ascites and reopening of umbilical vein were analyzed retrospectively and compared between the two groups.

Ninety-three infants were divided into 21 of cirrhosis group and 72 of non-cirrhosis group. In the cirrhosis group, 21 infants presented as thickened and enhanced echotexture of liver parenchyma, blunt hepatic margins, wave-like hepatic capsule and ascites; 14 appeared reopening of umbilical vein, significantly higher than those of the non-cirrhosis group, the differences were significant (χ²=73.78, 69.90, 93.04, 62.97, 56.51, all P<0.01). The splenic diameter, HAD, HAVmax, HARI in cirrhosis group were significantly higher than those in the non-cirrhosis group, the differences were significant (t=13.972, 2.984, 5.643, 6.930, all P<0.01). There was no significant difference in PVD between the two groups (t=0.516, P>0.05).

The degree of splenomegaly, thickened and enhanced echotexture of liver parenchyma, blunt hepatic margins, wave-like hepatic capsule, enlarged HAD, heighten of HARI, enhanced HAVmax, ascites and reopening of umbilical vein are important factors for the diagnosis of hepatic cirrhosis in the patients with BA.