Li Wenfeng,Chen Wenjuan,Zhou Mengjie,et al.Application value of Doppler ultrasonography in the diagnosis of hepatic artery stenosis after liver transplantation in children[J].Journal of Clinical Pediatric Surgery,,22():454-459.[doi:10.3760/cma.j.cn101785-202209034-010]
Application value of Doppler ultrasonography in the diagnosis of hepatic artery stenosis after liver transplantation in children
- Keywords:
- Liver Transplantation; Ultrasonography; Doppler; Hepatic Artery; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the ultrasonographic features and examine its diagnostic value in hepatic artery stenosis (HAS) after pediatric liver transplantation (LT).Methods Clinical data were retrospectively reviewed for 12 children undergoing LT from July 2018 to July 2022.Ultrasonic parameters of hepatic artery were detected,such as intrahepatic artery (IHA),peak systolic velocity (PSV),end-diastolic velocity (EDV),resistance index (RI),systolic acceleration time (SAT),extrahepatic artery (EHA) and peak systolic velocity (PSV).They were assigned into two groups of HAS and non-HAS according to the findings of computed tomography angiography (CTA).The relevant ultrasonic parameters were statistically compared between two groups.And the diagnostic values of ultrasound parameters for HAS after pediatric LT were evaluated.Results IHA RI was higher in normal group than that in HAS group[(0.68±0.65) vs.(0.43±0.95)](P=0.007).IHA SAT in normal group was lower than that in HAS group[(0.03±0.01) vs.(0.07±0.01) s](P<0.001).IHA PSV was higher in normal group than than in HAS group[(52.46±8.84)cm/s vs.(36.11±4.43)cm/s](P<0.001).EHA PSV was lower in normal group than that in HAS group[(92.54±6.54) vs.(192.53±9.66) cm/s](P<0.001).No significant inter-group difference existed between IHA EDV (P>0.05).The AUC of IHA PSV for diagnosing HAS was 0.743 (95%CI:0.583-0.886) with a sensitivity of 0.539 and a specificity of 0.793 and the corresponding diagnostic cutoff was 36.2 cm/s.The AUC of IHA EDV for diagnosing HAS was 0.664 (95%CI:0.498-0.831) with a sensitivity of 0.642 and a specificity of 0.969 and the corresponding diagnostic cutoff was 18.96 cm/s.The AUC of IHA RI for diagnosing HAS was 0.914 (95%CI:0.835-0.992) with a sensitivity of 0.876 and a specificity of 0.869 and the corresponding diagnostic cutoff was 0.57.The AUC of IHA SAT diagnosing HAS was 0.828 (95%CI:0.689-0.958) with a sensitivity of 0.822 and a specificity of 0.914 and the corresponding diagnostic cutoff was 0.04 s.The AUC of EHA PSV for diagnosing HAS was 0.668 (95%CI:0.511-0.826) with a sensitivity of 0.542 and a specificity of 0.992 and the corresponding diagnostic cutoff was 194.7 cm/s.The AUC of RI tandem STA for diagnosing HAS was 0.813 (95%CI:0.660-0.965) with a sensitivity of 0.642 and a specificity of 0.985.The AUC of RI and STA for diagnosing AS was 0.899 (95%CI:0.771-1.000) with a sensitivity of 0.936 and a specificity of 0.725.Conclusion Ultrasound has some value in the diagnosis of HAS after LT.A decrease of RI in IHA,a prolongation of SAT and the combination of the two help to diagnose the occurrence of HAS after LT in children.
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Memo
收稿日期:2022-9-21。
基金项目:湖南省卫生健康委员会项目(202109021301)
通讯作者:刘金桥,Email:826423695@qq.com