Value of duplex doppler ultrasonography in non-invasive assessment of children with chronic liver disease

Abstract

duplex Doppler added to grayscale US can detect significant morphologic and portal hemodynamic changes that correlate with the severity (stage) of CLD, but not with etiology.

Liver and systemic hemodynamics in children with cirrhosis: Impact on the surgical management in pediatric living donor liver transplantation

“…This finding was also reported in the work of El-Shabrawi et al, which showed a reduction in PV flow velocity using Doppler ultrasound according to Child-Pugh classification in a pediatric population. (38) Considering these results, cirrhosis in children may also be considered as a hemodynamic disease of the liver. According to our clinical experience in more than 1000 LTs in children at our center, noninvasive hemodynamic parameters collected preoperatively using Doppler ultrasound may be considered as additional elements for evaluation of the degree of emergency for LT.…”

Identification of liver fibrosis using the hepatic vein waveform in patients with Fontan circulation

“…The HV waveforms have also been reported to be useful for estimation of liver fibrosis in pediatric CLD patients. 26,33 Therefore, we consider that our new classification of HV waveforms developed based on adult CLD patients can also be applicable to pediatric CLD patients. Strikingly, Fontan patients showed HV waveform patterns similar to those commonly seen in CLD patients; therefore, the HV waveform changes were assumed to reflect the progression of liver fibrosis in Fontan patients.…”

“…As liver fibrosis increases parenchymal stiffness and reduces compliance of the HV wall, the HV waveform becomes flattened, changing from triphasic to biphasic and then monophasic, in line with liver fibrosis progression . Such findings were first reported in 1991 and attracted attention as a simple non‐invasive diagnostic tool for liver fibrosis . However, recent advances in tissue elastography have afforded quantitative estimates of liver fibrosis and supplanted HV waveform examination.…”

“…22 Such findings were first reported in 1991 and attracted attention as a simple non-invasive diagnostic tool for liver fibrosis. [23][24][25][26] However, recent advances in tissue elastography have afforded quantitative estimates of liver fibrosis and supplanted HV waveform examination. Nevertheless, as mentioned above, liver stiffness is not reliable when evaluating liver fibrosis in Fontan patients.…”

Jaundice as the first manifestation of primary biliary cirrhosis during pregnancy: Measurement of portal vein blood flow

“…Portal blood flow decreases in cirrhosis and its decrement reflects disease severity, 4 so it was measured, being the first observation in a pregnant woman with PBC to our knowledge. Her portal flow velocity increased during pregnancy, similar to healthy pregnant women 5 .…”