Predicting the presence of an accessory hepatic vein using abdominal computed tomography / Predicción de la presencia de una vena hepática accesoria mediante tomografía computarizada abdominal

The incidence of detection of accessory hepatic vein (AHV) using MRI or CT has been reported. However, previous studies had a small sample size or only reported on the incidence of hepatic vein variants. To the best of our knowledge, there has been no previous report evaluating the factors predictive of the presence of an AHV. To evaluate the incidence and morphology of the accessory hepatic vein (AHV) using multidetector row computed tomography (MDCT) and to investigate the factors which may be helpful in predicting the presence of an AHV. We enrolled 360 patients who underwent abdominal MDCT. We investigated whether the AHV was present and evaluated the frequency of AHVs greater than 5 mm in diameter. We classified the morphology of the AHV entering the inferior vena cava (IVC). We also examined the factors that predicted the presence of an AHV by comparing the diameter of the middle hepatic vein (MHV) and the right hepatic vein (RHV). We identified an AHV in 164 of the 360 patients (45.6 %). Among the 164 AHVs, 56.7 % were larger than 5 mm in diameter. The most common morphologies of the inferior RHV were a single main trunk (58.5 %), followed by two main trunks with a V-shape (19.5 %) and two trunks entering the IVC separately (17.0 %). The possibility that an AHV will be present was significantly higher when the diameter of the RHV was smaller than that of the MHV. MDCT can provide important information regarding AHV incidence and morphology. The possibility of an AHV being present was significantly higher when the diameter of the RHV was smaller than that of the MHV.

Se ha informado de la incidencia de la detección de la vena hepática accesoria (VHA) mediante RM o TC. Sin embargo, estudios previos tenían un tamaño muestral pequeño o solo informaban sobre la incidencia de variantes de las venas hepáticas. Hasta donde sabemos, no ha habido ningún informe previo que evalúe los factores predictivos de la presencia de una VHA. El objetivo del estudio fue evaluar la incidencia y morfología de la vena hepática accesoria (VHA) mediante tomografía computarizada multidetector (TCMD) e investigar los factores que pueden ser útiles para predecir la presencia de un VHA. Se evaluaron 360 pacientes que se sometieron a TCMD abdominal. Se investigó si la VHA estaba presente y se evaluó la frecuencia de VHA mayores de 5 mm de diámetro. Se clasificó la morfología del VHA que drenaba en la vena cava inferior (VCI). Además, se examinaron los factores que predijeron la presencia de una VHA mediante la comparación del diámetro de la vena hepática media (VHM) y la vena hepática derecha (VHD). Se identificó un VHA en 164 de los 360 pacientes (45,6%). Entre las 164 VHA, el 56,7% tenía más de 5 mm de diámetro. Las morfologías más frecuentes del VHD inferior fueron un tronco principal único (58,5%), seguido por dos troncos principales con forma de V (19,5%) y dos troncos que drenaban en la VCI por separado (17,0%). La posibilidad de que una VHA esté presente fue significativamente mayor cuando el diámetro de la VHD era menor que la de la VHM. La MDCT puede proporcionar información importante sobre la incidencia de la VHA y su morfología. La posibilidad de que un VHA estuviera presente era significativamente mayor cuando el diámetro del VHD era menor que la VHM.

Clinical characteristics of kawasaki disease according to age at diagnosis.

Objective: We compared the clinical, laboratory and diagnostic features of Kawasaki disease (KD) in children £6 mo and ³5 y of age to those in the more typical age range at diagnosis (6 mo-5 y of age). Study design: Retrospective analysis. Setting: Severeance Children Hospital attached to a Medical School, Korea. Methods: All children with a discharge diagnosis of KD at Severance Children’s Hospital (2006-2007) were retro-spectively reviewed and grouped according to age at presentation in 3 groups: <6 mo, 6 mo-5 y and ³5 years. Clinical, hematological, and biochemical features and involvement of coronary artery and proportion of Classic vs. Incomplete KD were compared between the 3 groups. Results: A total of 185 children were identified. Complete KD was found in 63 (34%) children and Incomplete KD in 122 (66%). There was 22(12%) children below 6 months of age, 131 (71%) between 6 months to 5 years) and 32 (17%) above 5 years of age. Clinical, hematological and biochemical features were comparable between the three age groups. Overall, coronary artery lesions occurred in 9% children without any preference for age. The proportion of Classical vs. Incomplete KD was also similar in the three age categories. Conclusion: The clinical and laboratory phenotype of KD does not vary significantly with age.