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Real-time and Doppler US after pediatric segmental liver transplantation : I. Portal vein stenosis
Lisa Suzuki1, Ilka R S de Oliveira, Azzo Widman
1Department of Radiology, Child Institute of University of São Paulo Medical School, São Paulo, Brazil. Lisa.suzuki@gmail.com
Insights
A portal vein (PV) diameter less than 3.5 mm, measured by color Doppler ultrasound (CD-US), accurately predicts stenosis after pediatric liver transplants. This non-invasive method helps avoid complications and unnecessary procedures.
Area of Science:
- Pediatric Surgery
- Vascular Imaging
- Transplantation Medicine
Background:
- Accurate diagnosis of portal vein (PV) stenosis is crucial after pediatric segmental liver transplantation.
- Real-time and color Doppler ultrasonography (CD-US) can reduce morbidity by preventing unnecessary biopsies and complications like PV hypertension or thrombosis.
Purpose of the Study:
- To assess CD-US parameters for predicting PV stenosis in children post-liver transplant.
- To identify reliable ultrasound markers for early detection of PV stenosis.
Main Methods:
- Retrospective review of 61 CD-US examinations in pediatric liver transplant recipients.
- Measurement of PV diameter at anastomosis, velocities (PV1, PV2), and PV1/PV2 ratio.
- Comparison of CD-US findings with angiography confirmation of stenosis.
Main Results:
- PV stenosis was identified in 12 CD-US examinations.
- The mean PV diameter was significantly smaller in patients with stenosis (2.6 mm vs. 5.7 mm).
- A PV diameter <3.5 mm demonstrated high predictive value (100% sensitivity, 91.8% specificity) for stenosis.
Conclusions:
- A portal vein diameter below 3.5 mm is a highly sensitive and specific CD-US indicator of hemodynamically significant stenosis.
- CD-US measurement of PV diameter is a valuable tool for diagnosing stenosis after pediatric liver transplantation.
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.
Materials And 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%).
Conclusion:
A PV diameter of <3.5 mm is a highly predictive CD-US parameter for the detection of hemodynamically significant stenosis on angiography.
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