Objective To investigate the value of shear wave elastography (SWE) in the differential diagnosis of biliary atresia (BA) in infants within 60 days.Methods SWE was used to detect the hepatic Young's modulus of 85 infants within 60 days who were suspected with cholestatic hepatitis.All the patients were classified into BA group and non biliary atresia (Non-BA) group according to surgical or pathological results.At the same time,45 normal infants within 60 days were selected as the control group.The hepatic Young's modulus were compared among the 3 groups.The sensitivity and specificity of hepatic Young's modulus in suspected BA patients were calculated by ROC.Results In the 85 cases,42 cases were diagnosed as BA,and 43 cases were classified as Non-BA group.The Young's modulus values of the 3 groups were as follows:BA group (15.86 ± 5.89) kPa,Non-BA group (10.89 ± 2.38) kPa,and control group (6.64 ± 0.53)kPa,with a significant difference among the 3 groups(P <0.01).The ROC analysis showed a cut off value of 12.9 kPa for differentiation between BA group and Non-BA group.The area under ROC curve (AUROC) was 0.787,with a sensitivity of 59.5% and a specificity of 88.4%.Conclusions The young's modulus in BA patients can be increased at early time,and the SWE technique can be used to reflect the change of hepatic Young's modulus accurately,which will be helpful in the early differential diagnosis of BA.