Pediatric Radiology

, Volume 37, Issue 8, pp 813–817 | Cite as

Reproducibility of measurements of hepatic artery and portal vein diameter and flow velocity in paediatricliver transplant recipients

  • Terry HumphreyEmail author
  • Constance Bainbridge
  • Mark Stringer
Original Article



Hepatic blood flow is critical for successful liver transplantation. To reliably calculate flow, vessel cross-sectional area and mean flow velocities must be reproducibly measurable.


To assess the reproducibility of sonographic measurements of portal vein (PV) and hepatic artery (HA) diameters and mean flow velocities in children after transplantation.

Materials and methods

Ten children were scanned by two operators 5 or 7 days after transplantation. Each scanned the same patient twice measuring the diameter and the time-averaged velocity (TAV) in the PV and HA. Operators were blinded to all measurements. Agreement and repeatability were analysed statistically.


The interobserver variation in PV and HA diameters and TAVs were expressed as mean differences between operators and plotted against the mean value for each. This showed relatively poor agreement for PV diameter (mean difference 1.23 ± 0.96 mm), but better agreement for HA diameter (mean difference 0.18 ± 0.6 mm). Intraobserver differences were of similar magnitude. TAVs showed better agreement and repeatability.


This study demonstrates substantial inter- and intraobserver variation in sonographic measurements of vessel diameters and TAV after paediatric liver transplantation. Estimates of volume of blood flow to the transplant derived from these measurements are poorly reproducible.


Liver Transplantation Ultrasound Measurement Blood flow Children 


  1. 1.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310CrossRefGoogle Scholar
  2. 2.
    Stringer MD (2002) Liver transplantation: complications and their management. In: Howard ER, Stringer MD, Colombani PM (eds) Surgery of the liver, bile-ducts and pancreas in children, 2nd edn. Arnold, London, pp 441–464Google Scholar
  3. 3.
    Thrush A (2003) Spectral Doppler ultrasound. In: Hoskins P, Thrush A, Martin K et al (eds) Diagnostic ultrasound physics and equipment. Greenwich Medical Media, London, pp 113–127Google Scholar
  4. 4.
    Bolognesi M, Sacerdoti D, Bombonato G et al (2002) Change in portal flow after liver transplantation: effect on hepatic arterial resistance indices and role of spleen size. Hepatology 35:601–608PubMedCrossRefGoogle Scholar
  5. 5.
    Stell D, Downey D, Marotta P et al (2004) Prospective evaluation of the role of quantitative Doppler ultrasound surveillance in liver transplantation. Liver Transpl 10:1183–1188PubMedCrossRefGoogle Scholar
  6. 6.
    Rasmussen A, Hjortrup A, Kirkegaard P (1997) Intraoperative measurement of graft blood flow – a necessity in liver transplantation. Transpl Int 10:74–77PubMedCrossRefGoogle Scholar
  7. 7.
    Garcia-Valdecasas JC, Fuster J, Charco R et al (2003) Changes in portal vein flow after adult living-donor liver transplantation: does it influence postoperative liver function? Liver Transpl 9:564–569PubMedCrossRefGoogle Scholar
  8. 8.
    Smyrniotis V, Kostopanagiotou G, Kondi A et al (2002) Hemodynamic interaction between portal vein and hepatic artery flow in small-for-size split liver transplantation. Transpl Int 15:355–360PubMedCrossRefGoogle Scholar
  9. 9.
    Payen DM, Fratacci MD, Dupuy P et al (1990) Portal and hepatic arterial blood flow measurements of human transplanted liver by implanted Doppler probes: interest for early complications and nutrition. Surgery 107:417–427PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Terry Humphrey
    • 1
    Email author
  • Constance Bainbridge
    • 1
  • Mark Stringer
    • 2
  1. 1.Ultrasound DepartmentSt James’s University HospitalLeedsUK
  2. 2.Children’s Liver & GI UnitSt James’s University HospitalLeedsUK

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