title: Real-time and Doppler US after pediatric segmental liver transplantation : I. Portal vein stenosis.
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 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.
  
  
  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%).
  
  
  CONCLUSIONS
  A PV diameter of <3.5 mm is a highly predictive CD-US parameter for the detection of hemodynamically significant stenosis on angiography.
authors.affiliation: Department of Radiology, Child Institute of University of São Paulo Medical School, São Paulo, Brazil. Lisa.suzuki@gmail.com
authors.forename: Lisa
authors.initials: L
authors.lastname: Suzuki
authors.forename: Ilka R S
authors.initials: IR
authors.lastname: de Oliveira
authors.forename: Azzo
authors.initials: A
authors.lastname: Widman
authors.forename: Nelson E M
authors.initials: NE
authors.lastname: Gibelli
authors.forename: Nelson E M
authors.initials: NE
authors.lastname: Gibeli
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Carnevale
authors.forename: João G
authors.initials: JG
authors.lastname: Maksoud
authors.forename: Anne M
authors.initials: AM
authors.lastname: Hubbard
authors.forename: Giovanni G
authors.initials: GG
authors.lastname: Cerri
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color