Doppler-ultrasound reference values after pediatric liver transplantation: a consecutive cohort study.

Autor: Verhagen MV; Department of Radiology, University of Groningen, University Medical Center Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands. m.verhagen@umcg.nl., de Kleine RH; Department of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Groen H; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van der Doef HPJ; Department of Pediatric Gastroenterology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Kwee TC; Department of Radiology, University of Groningen, University Medical Center Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands., de Haas RJ; Department of Radiology, University of Groningen, University Medical Center Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2023 Sep; Vol. 33 (9), pp. 6404-6413. Date of Electronic Publication: 2023 Mar 17.
DOI: 10.1007/s00330-023-09522-2
Abstrakt: Objectives: Doppler ultrasound (DUS) is the main imaging modality to evaluate vascular complications of pediatric liver transplants (LT). The current study aimed to determine reference values and their change over time.
Methods: A consecutive cohort of pediatric patients undergoing an LT were retrospectively included between 2015 and 2020. Timepoints for standardized DUS were intra-operative and postoperative (day 0), days 1-7, months 1 and 3, and years 1 and 2. DUS measurements of the hepatic artery (HA), portal vein (PV), and hepatic vein(s) (HV) were included if there were no complications during 2 years follow-up. Measurements consisted of: peak systolic velocity (PSV) and resistive index (RI) for the HA, PSV for the PV, and venous pulsatility index (VPI) for the HV. Generalized estimating equations were used to analyze change over time.
Results: One hundred twelve pediatric patients with 123 LTs were included (median age 3.3 years, interquartile range 0.7-10.1). Ninety-five HAs, 100 PVs, and 115 HVs without complications were included. Reference values for HA PSV and RI, PV PSV, and HV VPI were obtained for all timepoints (4043 included data points in total) and presented using 5 th -95 th percentiles and threshold values. All reference values changed significantly over time (p = 0.032 to p < 0.001).
Conclusions: DUS reference values of hepatic vessels in children after LT are presented, reference values change over time with specific vessel-dependent patterns. Timepoint-specific reference values improve the interpretation of DUS values and may help to better weigh their clinical significance.
Key Points: • Doppler ultrasound reference values of pediatric liver transplantations are not static but change over time. Applying the correct reference values for the specific timepoint may further improve the interpretation of the measurements. • The pattern of change over time of Doppler ultrasound measurements differs between the hepatic vessel and measurement; knowledge of these patterns may help radiologists to better understand normal postoperative hemodynamic changes.
(© 2023. The Author(s).)
Databáze: MEDLINE
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