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Society for Pediatric Radiology – Poster Archive
Final ID: Poster #: SCI-014
Liver Doppler findings in pediatric patients after Total Pancreatectomy and Islet Autotransplantation
Purpose or Case Report: Total pancreatectomy and islet autotransplantation (TPIAT) has become an increasingly utilized option for pain management in pediatric patients with chronic and hereditary pancreatitis. Doppler ultrasound of the liver is routinely used to evaluate patency of the portal vein and assess portal vein and hepatic artery velocities after this procedure. However, to the best of our knowledge no study has established the expected Doppler findings on pediatric patients after TPIAT. This study is intended to establish normal values for velocities in the hepatic artery and portal vein in pediatric patients after TPIAT, and to determine the rate of hepatic vascular complications in these patients.
Methods & Materials: We performed a retrospective review of the liver Doppler ultrasound studies obtained during the inpatient hospitalization after TPIAT in pediatric patients at our institution over 4 years. Doppler velocities in the main portal vein, branch portal veins and hepatic artery were recorded. Hepatic artery resistive index and patency of flow within the hepatic veins were recorded. The patient’s imaging and medical record were reviewed for postoperative liver vascular complications.
Results: 70 pediatric patients were evaluated. Patient ages ranged from 3.1 years to 17.7 years and the average age at transplant was 11.6 years. There were no cases of portal vein thrombosis or other hepatic vascular complication. The average hepatic artery peak systolic velocity was 158 cm/s (range 57-369 cm/s), with an average RI of 0.57 (range 0.35-0.85). The average main portal vein velocity was 32 cm/s (range 12-84 cm/s).
Conclusions: Portal vein thrombosis is rare in pediatric patients after TPIAT. In our study no hepatic vascular complications were encountered. Doppler evaluation is useful in detecting portal vein thrombosis. However, a wide range of hepatic artery and portal vein velocities are encountered in children immediately after TPIAT without hepatic vascular complications and can be considered normal.
Methods & Materials: We performed a retrospective review of the liver Doppler ultrasound studies obtained during the inpatient hospitalization after TPIAT in pediatric patients at our institution over 4 years. Doppler velocities in the main portal vein, branch portal veins and hepatic artery were recorded. Hepatic artery resistive index and patency of flow within the hepatic veins were recorded. The patient’s imaging and medical record were reviewed for postoperative liver vascular complications.
Results: 70 pediatric patients were evaluated. Patient ages ranged from 3.1 years to 17.7 years and the average age at transplant was 11.6 years. There were no cases of portal vein thrombosis or other hepatic vascular complication. The average hepatic artery peak systolic velocity was 158 cm/s (range 57-369 cm/s), with an average RI of 0.57 (range 0.35-0.85). The average main portal vein velocity was 32 cm/s (range 12-84 cm/s).
Conclusions: Portal vein thrombosis is rare in pediatric patients after TPIAT. In our study no hepatic vascular complications were encountered. Doppler evaluation is useful in detecting portal vein thrombosis. However, a wide range of hepatic artery and portal vein velocities are encountered in children immediately after TPIAT without hepatic vascular complications and can be considered normal.
More abstracts on this topic:
Intra-operative Doppler Sonogram in Pediatric Liver Transplant Patients: Correlation with surgical findings and post-operative imaging.
Stanescu Luana, Kamps Shawn, Dick Andre, Phillips Grace
Cracking the Nut With Ultrasound – Added Utility of Peak Systolic Velocity Ratios to Left Renal Vein Diameters in the Evaluation of Suspected Nutcracker Syndrome in ChildrenChew Lay Ee, Tan Timothy Shao Ern
Poster____SCI-014.pdf
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