Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children: a potential quantitative index for venous complications

Hirofumi Tomita, Yasushi Fuchimoto, Kiyoshi Ohkuma, Ken Hoshino, Akihiro Fujino, Mototoshi Kato, Takumi Fujimura, Hideo Ishihama, Nobuhiro Takahashi, Yutaka Tanami, Seishi Nakatsuka, Hirotoshi Ebinuma, Hidetsugu Saito, Masahiro Shinoda, Yuukou Kitagawa, Tatsuo Kuroda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients.

Objective: To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation.

Materials and methods: We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50% stenosis on multiphasic computed tomography.

Results: After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100% sensitivity and 78.9% specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure.

Conclusion: Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.

Original languageEnglish
JournalPediatric Radiology
DOIs
Publication statusAccepted/In press - 2014 Dec 12

Fingerprint

Elasticity Imaging Techniques
Living Donors
Liver Transplantation
Spleen
Pathologic Constriction
Liver
Portal Hypertension
Pediatrics
Interventional Radiology
Allografts
Tomography
Biopsy
Sensitivity and Specificity

Keywords

  • Acoustic radiation force impulse imaging
  • Child
  • Complications
  • Living donor liver transplantation
  • Portal hypertension
  • Spleen stiffness measurement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health

Cite this

Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children : a potential quantitative index for venous complications. / Tomita, Hirofumi; Fuchimoto, Yasushi; Ohkuma, Kiyoshi; Hoshino, Ken; Fujino, Akihiro; Kato, Mototoshi; Fujimura, Takumi; Ishihama, Hideo; Takahashi, Nobuhiro; Tanami, Yutaka; Nakatsuka, Seishi; Ebinuma, Hirotoshi; Saito, Hidetsugu; Shinoda, Masahiro; Kitagawa, Yuukou; Kuroda, Tatsuo.

In: Pediatric Radiology, 12.12.2014.

Research output: Contribution to journalArticle

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abstract = "Background: Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients.Objective: To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation.Materials and methods: We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50{\%} stenosis on multiphasic computed tomography.Results: After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100{\%} sensitivity and 78.9{\%} specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure.Conclusion: Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.",
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author = "Hirofumi Tomita and Yasushi Fuchimoto and Kiyoshi Ohkuma and Ken Hoshino and Akihiro Fujino and Mototoshi Kato and Takumi Fujimura and Hideo Ishihama and Nobuhiro Takahashi and Yutaka Tanami and Seishi Nakatsuka and Hirotoshi Ebinuma and Hidetsugu Saito and Masahiro Shinoda and Yuukou Kitagawa and Tatsuo Kuroda",
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T1 - Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children

T2 - a potential quantitative index for venous complications

AU - Tomita, Hirofumi

AU - Fuchimoto, Yasushi

AU - Ohkuma, Kiyoshi

AU - Hoshino, Ken

AU - Fujino, Akihiro

AU - Kato, Mototoshi

AU - Fujimura, Takumi

AU - Ishihama, Hideo

AU - Takahashi, Nobuhiro

AU - Tanami, Yutaka

AU - Nakatsuka, Seishi

AU - Ebinuma, Hirotoshi

AU - Saito, Hidetsugu

AU - Shinoda, Masahiro

AU - Kitagawa, Yuukou

AU - Kuroda, Tatsuo

PY - 2014/12/12

Y1 - 2014/12/12

N2 - Background: Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients.Objective: To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation.Materials and methods: We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50% stenosis on multiphasic computed tomography.Results: After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100% sensitivity and 78.9% specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure.Conclusion: Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.

AB - Background: Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients.Objective: To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation.Materials and methods: We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50% stenosis on multiphasic computed tomography.Results: After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100% sensitivity and 78.9% specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure.Conclusion: Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.

KW - Acoustic radiation force impulse imaging

KW - Child

KW - Complications

KW - Living donor liver transplantation

KW - Portal hypertension

KW - Spleen stiffness measurement

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