title: Multidetector CT findings of splenic artery aneurysm in children with chronic liver disease.
abstract: BACKGROUND
  Splenic artery aneurysm (SAA) is a well-known complication of chronic liver disease and portal hypertension in adults. The incidence of SAA in children undergoing selective hepatic angiography prior to liver transplantation is reported as 4%, but there are few systematic studies.
  
  
  OBJECTIVE
  To investigate the SAAs detected by multidetector CT angiography (MDCTA) among children with chronic liver disease.
  
  
  METHODS
  A total of 124 children (71 girls, 53 boys; mean age 118 months; age range 5 days to 204 months) with chronic liver disease underwent MDCTA to display the vascular anatomy and any vascular complications during the pretransplantation period. Of these children, 23 also underwent coeliac angiography. The digital subtraction angiography (DSA) and MDCTA findings were compared.
  
  
  RESULTS
  SAAs were detected in 13 children (10.4%); none was detectable by US. All patients had more than one aneurysm; ten patients had more than three. In all except one patient, the SAAs were located only in the intraparenchymal branches of the splenic artery; in one patient they were located in the intraparenchymal segment and in the distal third of the splenic artery. The mean size of the aneurysms was 6.5 mm (range 2.5-18 mm). All patients with aneurysms had splenomegaly and vascular collaterals. Nine of the children with SAAs had portal vein pathologies (two occlusions, two stenoses, five dilatations). A statistically significant difference existed with regard to the size of spleen (P < 0.05) and patient age (P < 0.05) between children with SAAs and children without SAAs. There was an increased risk of SAAs in patients with portal vein pathologies. In 19 patients without SAAs on MDCTA, no SAAs were seen on DSA.
  
  
  CONCLUSIONS
  It is likely that the incidence of SAA in children with chronic liver disease will increase with improved survival of children with long-standing portal hypertension and chronic liver disease. MDCTA with multiplanar reconstruction is a noninvasive and effective means of imaging paediatric patients with SAAs, especially during the peritransplantation period, which is considered to be a time of significant risk for SAA rupture in this patient population.
authors: Department of Radiology, Başkent University Faculty of Medicine, Fevzi Cakmak cad. 10. Sok. No. 45 Bahçelievler, Ankara, Turkey. emkayahanulu@yahoo.com
authors: Esra Meltem Kayahan
authors: EM
authors: Ulu
authors: Ismail
authors: I
authors: Kirbas
authors: Feride Kural
authors: FK
authors: Emiroglu
authors: Banu
authors: B
authors: Cakir
authors: Ali
authors: A
authors: Harman
authors: Coskun
authors: C
authors: Bakar
authors: Mehmet
authors: M
authors: Coskun
mesh_terms: D000293:Adolescent; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D015901:Angiography, Digital Subtraction; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D013157:Splenic Artery / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media