ABSTRACT
Objective To investigate the ultrasonographic features and its diagnostic value in portal vein stenosis (PVS) after pediatric liver transplantation. Methods Clinical data of 84 pediatric recipients undergoing liver transplantation who were followed up by routine ultrasound were retrospectively analyzed. According to ultrasound and digital subtraction angiography (DSA) results, all recipients were divided into the normal group (n=57) and PVS group (n=27). The incidence of PVS was assessed by ultrasound. The measurement parameters consisted of diameter of portal vein anastomosis, flow velocity of portal vein anastomosis, hepatic artery velocity, resistance index (RI) of hepatic artery and maximum diameter of the spleen, etc. The ultrasound parameters were statistically compared between the PVS and normal groups. The diagnostic value of ultrasound parameters for PVS after pediatric liver transplantation was evaluated. Results The diameter of portal vein anastomosis in the normal group was significantly larger than that in the PVS group[(0.44±0.08) cm vs. (0.27±0.10) cm], and the flow velocity of portal vein anastomosis in normal group was significantly lower than in the PVS group[(43±12) cm/s vs. (119±58) cm/s] (both P < 0.001). The hepatic artery velocity, RI of hepatic artery and maximum diameter of the spleen did not significantly differ between two groups (all P > 0.05). The diameter of portal vein anastomosis for the optimal diagnosis of PVS in pediatric liver transplantation, pediatric liver transplantation from organ donation after citizen's death and living-related donor pediatric liver transplantation was 0.35 cm, 0.35 cm and 0.33 cm, respectively. The corresponding area under curve (AUC) was 0.906, 0.916 and 0.906, the sensitivity was 0.947, 0.951 and 0.938, and the specificity was 0.852, 0.833 and 0.889, respectively. The flow velocity of portal vein anastomosis for the optimal diagnosis of PVS was 62.7 cm/s, 69.6 cm/s and 61.2 cm/s. The AUC was 0.990, 0.993 and 1.000, the sensitivity was 1.000, 1.000 and 1.000, and the specificity was 0.930, 0.951 and 1.000. Conclusions Ultrasound features of the pediatric recipients with PVS after liver transplantation include the smaller diameter of portal vein anastomosis and faster anastomotic flow velocity, which possess high diagnostic value.