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01-08-2017 | Pediatric Ultrasound

Ultrasound of congenital and inherited disorders of the pediatric hepatobiliary system, pancreas and spleen

Authors: Susan J. Back, Carolina L. Maya, Asef Khwaja

Published in: Pediatric Radiology | Issue 9/2017

Abstract

Ultrasound is often the initial imaging examination performed of the solid organs of the pediatric abdomen. The sonographic appearance of the hepatobiliary system, pancreas and spleen changes with growth and development. This article reviews the normal US appearance of these organs in children and illustrates, through case examples, congenital and inherited conditions that affect them.

Rozel C, Garel L, Rypens F et al (2011) Imaging of biliary disorders in children. Pediatr Radiol 41:208–220CrossRefPubMed

Veigel MC, Prescott-Focht J, Rodriguez MG et al (2009) Fibropolycystic liver disease in children. Pediatr Radiol 39:317–327CrossRefPubMed

Yoneyama H, Kondo C, Yamasaki A et al (2015) Comparison of situs ambiguous patterns between heterotaxy syndromes with polysplenia and asplenia. Eur J Radiol 84:2301–2306CrossRefPubMed

American Institute of Ultrasound in Medicine (2008) AIUM practice guideline for the performance of an ultrasound examination of the abdomen and/or retroperitoneum. J Ultrasound Med 27:319–326CrossRef

Holder LE, Strife J, Padikal TN et al (1975) Liver size determination in pediatrics using sonographic and scintigraphic techniques. Radiology 117:349–353CrossRefPubMed

Konus OL, Ozdemir A, Akkaya A et al (1998) Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography. AJR Am J Roentgenol 171:1693–1698CrossRefPubMed

Dittrich M, Milde S, Dinkel E et al (1983) Sonographic biometry of liver and spleen size in childhood. Pediatr Radiol 13:206–211CrossRefPubMed

Soyupak SK, Narli N, Yapicioglu H et al (2002) Sonographic measurements of the liver, spleen and kidney dimensions in the healthy term and preterm newborns. Eur J Radiol 43:73–78CrossRefPubMed

Kahramaner Z, Erdemir A, Cicek E et al (2013) Reference ranges for sonographic dimensions of the liver and spleen in preterm infants. Pediatr Radiol 43:1464–1474CrossRefPubMed

10.

McGahan JP, Phillips HE, Cox KL (1982) Sonography of the normal pediatric gallbladder and biliary tract. Radiology 144:873–875CrossRefPubMed

11.

Chafetz N, Filly RA (1979) Portal and hepatic veins: accuracy of margin echoes for distinguishing intrahepatic vessels. Radiology 130:725–728CrossRefPubMed

12.

Shorbagi A, Bayraktar Y (2010) Experience of a single center with congenital hepatic fibrosis: a review of the literature. World J Gastroenterol 16:683–690CrossRefPubMedPubMedCentral

13.

Hanquinet S, Rougemont AL, Courvoisier D et al (2013) Acoustic radiation force impulse (ARFI) elastography for the noninvasive diagnosis of liver fibrosis in children. Pediatr Radiol 43:545–551CrossRefPubMed

14.

Kim OH, Chung HJ, Choi BG (1995) Imaging of the choledochal cyst. Radiographics 15:69–88CrossRefPubMed

15.

Mittal V, Saxena AK, Sodhi KS et al (2011) Role of abdominal sonography in the preoperative diagnosis of extrahepatic biliary atresia in infants younger than 90 days. AJR Am J Roentgenol 196:W438–W445CrossRefPubMed

16.

Zhou L, Shan Q, Tian W et al (2016) Ultrasound for the diagnosis of biliary atresia: a meta-analysis. AJR Am J Roentgenol 206:W73–W82CrossRefPubMed

17.

Leschied JR, Dillman JR, Bilhartz J et al (2015) Shear wave elastography helps differentiate biliary atresia from other neonatal/infantile liver diseases. Pediatr Radiol 45:366–375CrossRefPubMed

18.

Wang X, Qian L, Jia L et al (2016) Utility of shear wave elastography for differentiating biliary atresia from infantile hepatitis syndrome. J Ultrasound Med 35:1475–1479CrossRefPubMed

19.

Hanquinet S, Courvoisier DS, Rougemont AL et al (2015) Contribution of acoustic radiation force impulse (ARFI) elastography to the ultrasound diagnosis of biliary atresia. Pediatr Radiol 45:1489–1495CrossRefPubMed

20.

Subramaniam P, Knisely A, Portmann B et al (2011) Diagnosis of Alagille syndrome — 25 years of experience at King's College Hospital. J Pediatr Gastroenterol Nutr 52:84–89CrossRefPubMed

21.

Debray D, Kelly D, Houwen R et al (2011) Best practice guidance for the diagnosis and management of cystic fibrosis-associated liver disease. J Cyst Fibros 10:S29–S36CrossRefPubMed

22.

Bodewes FA, van der Doef HP, Houwen RH et al (2015) Increase of serum gamma-glutamyltransferase associated with development of cirrhotic cystic fibrosis liver disease. J Pediatr Gastroenterol Nutr 61:113–118PubMed

23.

Friedrich-Rust M, Schlueter N, Smaczny C et al (2013) Non-invasive measurement of liver and pancreas fibrosis in patients with cystic fibrosis. J Cyst Fibros 12:431–439CrossRefPubMed

24.

Mortele KJ, Rocha TC, Streeter JL et al (2006) Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics 26:715–731CrossRefPubMed

25.

Borghei P, Sokhandon F, Shirkhoda A et al (2013) Anomalies, anatomic variants, and sources of diagnostic pitfalls in pancreatic imaging. Radiology 266:28–36CrossRefPubMed

26.

Walsh E, Cramer B, Pushpanathan C (1990) Pancreatic echogenicity in premature and newborn infants. Pediatr Radiol 20:323–325CrossRefPubMed

27.

Siegel MJ, Martin KW, Worthington JL (1987) Normal and abnormal pancreas in children: US studies. Radiology 165:15–18CrossRefPubMed

28.

Chao HC, Lin SJ, Kong MS et al (2000) Sonographic evaluation of the pancreatic duct in normal children and children with pancreatitis. J Ultrasound Med 19:757–763CrossRefPubMed

29.

Yu J, Turner MA, Fulcher AS et al (2006) Congenital anomalies and normal variants of the pancreaticobiliary tract and the pancreas in adults: part 2, pancreatic duct and pancreas. AJR Am J Roentgenol 187:1544–1553CrossRefPubMed

30.

Jimenez JC, Emil S, Podnos Y et al (2004) Annular pancreas in children: a recent decade's experience. J Pediatr Surg 39:1654–1657CrossRefPubMed

31.

Johnston DW (1978) Annular pancreas: a new classification and clinical observations. Can J Surg 21:241–244PubMed

32.

Vijayaraghavan SB (2002) Sonography of pancreatic ductal anatomic characteristics in annular pancreas. J Ultrasound Med 21:1315–1318CrossRefPubMed

33.

Vijayaraghavan SB, Gouru S, Senthil S (2013) Sonographic features of agenesis of dorsal pancreas. Indian J Radiol Imaging 23:179–182CrossRefPubMedPubMedCentral

34.

Nijs E, Callahan MJ, Taylor GA (2005) Disorders of the pediatric pancreas: imaging features. Pediatr Radiol 35:358–373CrossRefPubMed

35.

Thoeni RF, Gedgaudas RK (1980) Ectopic pancreas: usual and unusual features. Gastrointest Radiol 5:37–42CrossRefPubMed

36.

Prasad TR, Gupta SD, Bhatnagar V (2001) Ectopic pancreas associated with a choledochal cyst and extrahepatic biliary atresia. Pediatr Surg Int 17:552–554CrossRefPubMed

37.

Hough DM, Stephens DH, Johnson CD et al (1994) Pancreatic lesions in von Hippel-Lindau disease: prevalence, clinical significance, and CT findings. AJR Am J Roentgenol 162:1091–1094CrossRefPubMed

38.

von Rohden L, Mohnike K, Mau H et al (2011) Intraoperative sonography: a technique for localizing focal forms of congenital hyperinsulinism in the pancreas. Ultraschall Med 32:74–80CrossRef

39.

Agrons GA, Corse WR, Markowitz RI et al (1996) Gastrointestinal manifestations of cystic fibrosis: radiologic-pathologic correlation. Radiographics 16:871–893CrossRefPubMed

40.

Swobodnik W, Wolf A, Wechsler JG et al (1985) Ultrasound characteristics of the pancreas in children with cystic fibrosis. J Clin Ultrasound 13:469–474CrossRefPubMed

41.

Donnelly LF, Emery KH, Bove KE et al (1996) Normal changes in the MR appearance of the spleen during early childhood. AJR Am J Roentgenol 166:635–639CrossRefPubMed

42.

Hilmes MA, Strouse PJ (2007) The pediatric spleen. Semin Ultrasound CT MR 28:3–11CrossRefPubMed

43.

Rosenberg HK, Markowitz RI, Kolberg H et al (1991) Normal splenic size in infants and children: sonographic measurements. AJR Am J Roentgenol 157:119–121CrossRefPubMed

44.

Megremis SD, Vlachonikolis IG, Tsilimigaki AM (2004) Spleen length in childhood with US: normal values based on age, sex, and somatometric parameters. Radiology 231:129–134CrossRefPubMed

45.

Nemati M, Hajalioghli P, Jahed S et al (2016) Normal values of spleen length and volume: an ultrasonographic study in children. Ultrasound Med Biol 42:1771–1778CrossRefPubMed

46.

Loftus WK, Metreweli C (1998) Ultrasound assessment of mild splenomegaly: spleen/kidney ratio. Pediatr Radiol 28:98–100CrossRefPubMed

47.

Mortele KJ, Mortele B, Silverman SG (2004) CT features of the accessory spleen. AJR Am J Roentgenol 183:1653–1657CrossRefPubMed

48.

Gayer G, Hertz M, Strauss S et al (2006) Congenital anomalies of the spleen. Semin Ultrasound CT MR 27:358–369CrossRefPubMed

49.

Paterson A, Frush DP, Donnelly LF et al (1999) A pattern-oriented approach to splenic imaging in infants and children. Radiographics 19:1465–1485CrossRefPubMed

50.

Lombardi R, Menchini L, Corneli T et al (2014) Wandering spleen in children: a report of 3 cases and a brief literature review underlining the importance of diagnostic imaging. Pediatr Radiol 44:279–288CrossRefPubMed

51.

Dodds WJ, Taylor AJ, Erickson SJ et al (1990) Radiologic imaging of splenic anomalies. AJR Am J Roentgenol 155:805–810CrossRefPubMed

52.

Fulcher AS, Turner MA (2002) Abdominal manifestations of situs anomalies in adults. Radiographics 22:1439–1456CrossRefPubMed

53.

Lee FT Jr, Pozniak MA, Helgerson RB (1993) US case of the day. Polysplenia syndrome. Radiographics 13:1159–1162

54.

Applegate KE, Goske MJ, Pierce G et al (1999) Situs revisited: imaging of the heterotaxy syndrome. Radiographics 19:837–852CrossRefPubMed

55.

Lonergan GJ, Cline DB, Abbondanzo SL (2001) Sickle cell anemia. Radiographics 21:971–994CrossRefPubMed

56.

McCarville MB, Rogers ZR, Sarnaik S et al (2012) Effects of chronic transfusions on abdominal sonographic abnormalities in children with sickle cell anemia. J Pediatr 160:281–285CrossRefPubMed

57.

Gale HI, Bobbitt CA, Setty BN et al (2016) Expected sonographic appearance of the spleen in children and young adults with sickle cell disease: an update. J Ultrasound Med 35:1735–1745CrossRefPubMed

58.

Donkol RH, Monib S, Eltounsi I (2006) Tumorlike, iron-sparing foci of splenic hemosiderosis in a child with sickle cell anemia. J Ultrasound Med 25:1607–1609CrossRefPubMed

Title: Ultrasound of congenital and inherited disorders of the pediatric hepatobiliary system, pancreas and spleen
Authors: Susan J. Back
Carolina L. Maya
Asef Khwaja
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 9/2017
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-017-3869-y

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Springer Medicine

Ultrasound of congenital and inherited disorders of the pediatric hepatobiliary system, pancreas and spleen

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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