title: Role of Doppler Sonography in Early Detection of Splenic Steal Syndrome.
abstract: OBJECTIVE
  To retrospectively investigate the role of Doppler sonography in the early detection of splenic steal syndrome.
  
  
  METHODS
  Fifty cases of splenic steal syndrome after orthotopic liver transplantation were identified. A control group was matched to the splenic steal syndrome group. Information was collected about the clinical presentation, liver enzyme levels, Doppler sonographic results, and follow-up after patients underwent splenic artery embolization.
  
  
  RESULTS
  A persistent hepatic arterial diastolic reversal waveform was observed in 25 patients with splenic steal syndrome versus 0 control patients. The mean hepatic arterial resistive index (RI) values ± SD were 0.95 ± 0.09 in patients with splenic steal syndrome and 0.80 ± 0.10 in control patients (P < .0001). One week after orthotopic liver transplantation, the area under the receiver operating characteristic curve for the RI was 0.884 (95% confidence interval, 0.793-0.975; P = .001) for splenic steal syndrome diagnosis. After splenic artery embolization, there was normalization of the reversal waveform, with an average RI of 0.77 ± 0.11 (P < .0001).
  
  
  CONCLUSIONS
  Dynamic changes in the hepatic arterial waveform and RI are keys to detecting splenic steal syndrome with Doppler sonography.
authors.affiliation: Department of Quantitative Health Sciences, and Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: Chaolun
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of General Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Quintini
authors.affiliation: Department of General Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of General Surgery, Liver Transplant Center, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: John
authors.initials: J
authors.lastname: Fung
authors.affiliation: Department of Quantitative Health Sciences, and Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Obuchowski
authors.affiliation: Department of Quantitative Health Sciences, and Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sands
authors.affiliation: Department of Quantitative Health Sciences, and Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio USA wang.weiping@mayo.edu.
authors.forename: Weiping
authors.initials: W
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D042241:Early Diagnosis; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008102:Liver Circulation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D013577:Syndrome; D018608:Ultrasonography, Doppler / Q000379:methods*; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
keywords: Doppler sonography; gastrointestinal ultrasound; liver transplantation; sonography; splenic artery