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Pediatric Radiology
Published in: Pediatric Radiology 2/2021

01-02-2021 | Liver Transplantation | Original Article

Initial experience with contrast-enhanced ultrasound in the first week after liver transplantation in children: a useful adjunct to Doppler ultrasound

Authors: Boaz Karmazyn, Dilek Sağlam, Giresh S. Rao, S. Gregory Jennings, Richard S. Mangus

Published in: Pediatric Radiology | Issue 2/2021

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Abstract

Background

Doppler US is the primary screening for post-liver transplant vascular complications, but indeterminate findings require further imaging.

Objective

To evaluate whether contrast-enhanced US improves diagnostic assessment of vascular complications suspected by Doppler US.

Materials and methods

We retrospectively reviewed Doppler US and contrast-enhanced US studies obtained in the first week following liver transplant. Doppler US was performed twice daily for the first 5 postoperative days, and CEUS in the first postoperative day and when vascular complications were suspected. We correlated Doppler US and CEUS with surgical findings, and clinical and imaging follow-up. We evaluated Doppler US and CEUS quality in demonstrating the main hepatic artery (HA) at the porta hepatis as follows: Grade 0 = not seen, Grade 1 = only segments, Grade 2 = entire main HA, and Grade 3 = entire main HA to the intrahepatic branching. We used a Wilcoxon signed rank test to test the difference between Doppler US and CEUS methods.

Results

Twenty-nine children (15 girls, 14 boys) were identified, with median age 2.2 years (range 0.5–17.6 years). The most common transplant indication was biliary atresia (n=13). There was significantly (P<0.0001) improved main HA visualization with CEUS. In five children, CEUS was performed to evaluate suspected vascular complications; CEUS confirmed normal vascularity in two. CEUS demonstrated portal vein thrombosis (n=2) and main HA thrombosis (n=1), confirmed at surgery. In one child the main HA thrombosis was missed; marked HA narrowing was seen retrospectively on CEUS.

Conclusion

Immediately following liver transplantation, CEUS improves main HA visualization and diagnostic assessment of vascular complications.
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Metadata
Title
Initial experience with contrast-enhanced ultrasound in the first week after liver transplantation in children: a useful adjunct to Doppler ultrasound
Authors
Boaz Karmazyn
Dilek Sağlam
Giresh S. Rao
S. Gregory Jennings
Richard S. Mangus
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 2/2021
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-020-04811-0

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