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Doppler waveform of hepatic veins in healthy children
S Jequier1, J C Jequier, S Hanquinet
1Department of Pediatric Radiology, University Hospital of Geneva, Children's Hospital, Switzerland.
Insights
Not all healthy children exhibit triphasic hepatic vein flow. Absence of triphasic flow does not always indicate hepatic abnormality, as normal variants exist in pediatric hepatic vein Doppler sonography.
Area of Science:
- Pediatric Radiology
- Hepatology
- Vascular Ultrasound
Background:
- Triphasic waveforms in hepatic veins are typically associated with normal cardiac function and hepatic venous outflow.
- Assessing hepatic vein flow patterns is crucial for diagnosing various liver conditions.
Purpose of the Study:
- To determine the prevalence of triphasic waveforms in the hepatic veins of healthy children.
- To investigate whether the absence of triphasic flow in hepatic veins suggests hepatic abnormality in pediatric populations.
Main Methods:
- Doppler sonography was performed on the hepatic veins of 100 healthy children (50 girls, 50 boys) across five age groups.
- Children with known hepatic or intrathoracic abnormalities were excluded from the study.
Main Results:
- Forty-two children demonstrated triphasic flow in all three hepatic veins.
- Neonates showed the highest incidence of monophasic flow (7/21), with none exhibiting triphasic flow in all veins.
- Hepatic veins with angles close to 90 degrees to the inferior vena cava showed reduced flow modulation.
Conclusions:
- A triphasic flow pattern is not universally present in all healthy children's hepatic veins.
- The absence of triphasic hepatic vein flow should not automatically be interpreted as hepatic abnormality; normal variants must be considered.
- A change from previously documented triphasic to monophasic flow in a specific hepatic vein is a more reliable indicator of potential abnormality.
Objective:
This study intends to document the presence or absence of triphasic waveforms in hepatic veins in healthy children. Does absence of triphasic hepatic vein flow indicate hepatic abnormality?
Subjects And Methods:
One hundred children without a known hepatic or intrathoracic abnormality underwent Doppler sonography of their hepatic veins. Fifty girls and 50 boys were divided into five age groups.
Results:
Forty-two children had triphasic flow in all three hepatic veins. Veins approaching an angle of 90 degrees with the inferior vena cava could not be assessed or had the least flow modulations despite angle correction. Neonates had the highest percentage of monophasic flow (seven of 21) in all three hepatic veins and none had triphasic flow in all three veins.
Conclusion:
Not all healthy children have a triphasic flow pattern in all hepatic veins. Before suspecting hepatic abnormality with abnormal parenchymal compliance (cirrhosis, graft rejection) by virtue of lack of triphasic hepatic vein flow, a normal variant of the flow should be considered. Only the change of a previously documented triphasic flow to monophasic flow in a given vein should be assessed as a sign of possible abnormality.