Real-time and Doppler US after pediatric segmental liver transplantation : I. Portal vein stenosis.

Suzuki L; de Oliveira IR; Widman A; Gibeli NE; Carnevale FC; Maksoud JG; Hubbard AM; Cerri GG; Suzuki, Lisa; de Oliveira, Ilka R S; Widman, Azzo; Gibelli, Nelson E M; Gibeli, Nelson E M; Carnevale, Francisco C; Maksoud, João G; Hubbard, Anne M; Cerri, Giovanni G

<bold>Background: </bold>Accurate diagnosis of portal vein (PV) stenosis by real-time and color Doppler US (CD-US) after segmental liver transplantation in children can decrease morbidity by avoiding unnecessary biopsy, PV hypertension, thrombosis and loss of the graft.<bold>Objective: </bold>To evaluate CD-US parameters for the prediction of PV stenosis after segmental liver transplantation in children.<bold>Materials and Methods: </bold>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.<bold>Results: </bold>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%).<bold>Conclusion: </bold>A PV diameter of <3.5 mm is a highly predictive CD-US parameter for the detection of hemodynamically significant stenosis on angiography.

Pediatric Radiology, 2008, Vol 38, Issue 4, p403

0301-0449

Academic Journal

10.1007/s00247-007-0733-5