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Pediatr Radiol (2008) 38:403408 DOI 10.1007/s00247-007-0733-5
ORIGINAL ARTICLE
Real-time and Doppler US after pediatric segmental liver transplantation
I. Portal vein stenosis
Lisa Suzuki & Ilka R. S. de Oliveira & Azzo Widman &
Nelson E. M. Gibeli & Francisco C. Carnevale &
Joo G. Maksoud & Anne M. Hubbard &
Giovanni G. Cerri
Received: 2 August 2007 / Revised: 13 November 2007 / Accepted: 7 December 2007 / Published online: 23 January 2008 # Springer-Verlag 2007
Abstract Background Accurate diagnosis of portal vein (PV) stenosis by real-time and color Doppler US (CD-US) after segmental liver transplantation in children can decrease
L. SuzukiDepartment of Radiology, Child Institute of University of So Paulo Medical School, So Paulo, Brazil
I. R. S. de Oliveira : G. G. Cerri Department of Radiology, University of So Paulo Medical School, So Paulo, Brazil
A. Widman Department of Digestive Surgery, Clinic Hospital, University of So Paulo Medical School, So Paulo, Brazil
N. E. M. Gibeli : J. G. Maksoud Department of Pediatric Surgery, Child Institute, University of So Paulo Medical School, So Paulo, Brazil
F. C. CarnevaleRadiology Institute, Clinic Hospital, University of So Paulo Medical School, So Paulo, Brazil
L. Suzuki (*)R. Alves Guimares, 623/132, CEP 05410-001 So Paulo, Brazil e-mail: [email protected]
A. M. Hubbard Department of Radiology, University of Nebraska Medical Center, Omaha, NE, USA
morbidity by avoiding unnecessary biopsy, PV hypertension, thrombosis and loss of the graft. Objective To evaluate CD-US parameters for the prediction of PV stenosis after segmental liver transplantation in children. Materials and methods We retrospectively reviewed 61 CD-US examinations measuring the diameter at the PV anastomosis, velocities at the anastomosis (PV1) and in the segment proximal to the anastomosis (PV2), and the PV1/ PV2 velocity ratio. The study group comprised patients with stenosis confirmed by angiography and the control group comprised patients with a good clinical outcome. Results PV stenosis was seen in 12 CD-US examinations. The mean PV diameter was smaller in the study group (2.6 mm versus 5.7 mm) and a PV diameter of <3.5 mm was highly predictive of stenosis (sensitivity 100%, specificity 91.8%). Conclusion A PV diameter of <3.5 mm is a highly predictive CD-US parameter for the detection of hemodynamically significant stenosis on angiography.
Keywords Color Doppler US . Portal vein...