Abstract:

Objective To investigate the application of ultrasound and enhancement CT in evaluation of portal vein and hepatic artery anomalies in pediatric patients undergoing living donor liver transplantation. Methods Thirty-three pediatric patients selected for living donor liver transplantation underwent examinations of ultrasound and enhancement CT before operation, surgical findings and gross pathology were served as golden standard, and the accuracy of ultrasound and enhancement CT in evaluation of portal vein and hepatic artery anomalies was determined. Results Hepatic artery and portal vein were surgically confirmed patent in all these 33 patients. There were significant differences in the accuracy of diagnosis of portal vein patency between ultrasound and enhancement CT (100% vs 63.6%, P<0.05). The accuracy of diagnosis of hepatic artery by ultrasound and enhancement CT was 100% and 100%, respectively. The partial pressure of oxygen and mean flow velocity of hepatic artery in hepatofugal flow group were significantly higher than those in hepatopetal flow group (P<0.05), and the wave pattern of artery-type was significantly higher than that of wall-type and wave-type (P<0.05). The sensitivity of ultrasound in detection of patent umbilical vein was 76.9%, and that of CT was 92.3%. CT could detect the other collateral circulation around the liver. The sensitivity of CT in diagnosis of hepatic artery variations was 83.3%, while ultrasound could not detect the variations of arteries. Conclusion Ultrasound has a high value in evaluation of direction and wave pattern of portal vein flow, and has higher accuracy in detection of portal vein patency than CT. Enhancement CT performs better in detection of hepatic artery variation and patent umbilical vein, and ultrasound and enhancement CT may complement with each other in evaluation of vascular anomalies for pediatric patients undergoing living donor liver transplantation.

Key words: pediatric living donor liver transplantation, CT, ultrasound