title: Real-time and Doppler US after pediatric segmental liver transplantation : II. Hepatic vein stenosis.
abstract: BACKGROUND
  Accurate diagnosis of hepatic vein (HV) stenosis by real-time and color Doppler US (CD-US) after segmental liver transplantation in children can decrease morbidity because it allows unnecessary biopsy, obstruction or thrombosis and loss of the graft to be avoided.
  
  
  OBJECTIVE
  To evaluate CD-US parameters to predict HV stenosis after segmental liver transplantation in children.
  
  
  METHODS
  Retrospective review of 79 CD-US examinations measuring velocity at the HV anastomosis (HV1) and the main trunk 1-2 cm proximal to the HV/IVC anastomosis (HV2), the HV1/HV2 ratio and the spectral waveform of HV2. The study group comprised patients with stenosis confirmed by angiography. The control group comprised patients with a good clinical outcome.
  
  
  RESULTS
  HV stenosis was seen in 12 CD-US examinations. The mean HV1/HV2 ratio was higher in the study group (6.0 versus 4.0). An HV1/HV2 ratio of >4.1 was predictive of HV stenosis (sensitivity 83%, specificity 76%).
  
  
  CONCLUSIONS
  An HV1/HV2 ratio of >4.1 is a highly predictive CD-US parameter for the detection of hemodynamically significant HV stenosis on angiography.
authors.affiliation: Department of Radiology, Child Institute, 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; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006504:Hepatic Veno-Occlusive Disease / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; 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