Real-time and Doppler US after pediatric segmental liver transplantation : I. Portal vein stenosis.
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.
Suzuki
Lisa
L
Department of Radiology, Child Institute of University of São Paulo Medical School, São Paulo, Brazil. Lisa.suzuki@gmail.com
de Oliveira
Ilka R S
IR
Widman
Azzo
A
Gibelli
Nelson E M
NE
Gibeli
Nelson E M
NE
Carnevale
Francisco C
FC
Maksoud
João G
JG
Hubbard
Anne M
AM
Cerri
Giovanni G
GG
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