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- Title
Gallbladder wall oedema and ascites are independent predictors of progression to hepatic veno-occlusive disease for children with hematopoietic stem cell transplantation.
- Authors
Park, Ji Eun; Choi, Young Hun; Cheon, Jung-Eun; Kim, Woo Sun; Kim, In-One; Ryu, Young Jin; Kim, Yu Jin; Hong, Che Ry; Kang, Hyoung Jin
- Abstract
<bold>Objectives: </bold>To evaluate the predictive value of ultrasonography in children with clinically suspicious hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation (HSCT).<bold>Methods: </bold>Among 216 children who underwent HSCT, 70 also underwent colour Doppler ultrasonography. Of these, 59 had only one sign/symptom, which did not fulfil the diagnostic criteria (clinical suspicion of VOD) at that time. VOD was confirmed in 20 patients (VOD group), while 39 had other conditions (non-VOD group). The following findings were reviewed and compared between groups: left portal vein (peak velocity, direction), left hepatic artery (peak-systolic/end-diastolic velocities, resistive index), middle hepatic vein (peak velocity, phasicity), hepatomegaly, splenomegaly, gallbladder wall thickness, and ascites.<bold>Results: </bold>The VOD group showed significantly higher reversed flow in portal vein (P = 0.011), peak systolic velocity of left hepatic artery (P = 0.028), monophasicity of middle hepatic vein (P = 0.015), hepatomegaly (P = 0.001), gallbladder wall thickness (P < 0.001), and ascites (P < 0.001). Multivariate regression revealed that gallbladder wall thickness and ascites (odds ratio = 35.370, 56.393) were associated with VOD.<bold>Conclusions: </bold>The presence of reversed flow in portal vein, increased peak systolic velocity of hepatic artery, monophasicity of hepatic vein, hepatomegaly, gallbladder wall thickness, and ascites were significantly associated with progression to VOD in children with clinically suspicious VOD after HSCT.<bold>Key Points: </bold>• Ultrasonography with Doppler can help predict progression to VOD. • Gallbladder wall oedema and ascites are the independent predictors of progression to VOD.
- Subjects
EDEMA; STEM cell transplantation; SURGICAL complications; HEPATIC encephalopathy; DOPPLER ultrasonography; ASCITES; BLOOD flow measurement; COMPARATIVE studies; GALLBLADDER diseases; HEMATOPOIETIC stem cell transplantation; HEMODYNAMICS; HEPATIC artery; RESEARCH methodology; MEDICAL cooperation; PORTAL vein; PROGNOSIS; RESEARCH; ULTRASONIC imaging; EVALUATION research; COLOR Doppler ultrasonography; DISEASE progression; HEPATIC veins; HEPATIC veno-occlusive disease
- Publication
European Radiology, 2018, Vol 28, Issue 6, p2291
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-5137-9