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Doppler Waveform of Hepatic Veins in Healthy Children

S. Jequier1, J. C. Jequier1, S. Hanquinet1, J. Gong1, C. Le Coultre2 and D. C. Belli3

1 Department of Pediatric Radiology, University Hospital of Geneva, Children's Hospital, 6 rue Willy Donzé, 1112 Geneva, Switzerland.
2 Department of Pediatric Surgery, University Hospital of Geneva, 1112 Geneva, Switzerland.
3 Department of Pediatric Gastroenterology, University Hospital of Geneva, 1112 Geneva, Switzerland.



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  		Fig. 1A. —3-week-old male neonate with suspected but unconfirmed pyloric stenosis. Doppler sonograms of three hepatic veins reveal triphasic flow pattern in left hepatic vein by both anterior (A) and lateral (B) approaches and monophasic flow pattern in right (C) and middle (D) hepatic veins.

 


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  		Fig. 1B. —3-week-old male neonate with suspected but unconfirmed pyloric stenosis. Doppler sonograms of three hepatic veins reveal triphasic flow pattern in left hepatic vein by both anterior (A) and lateral (B) approaches and monophasic flow pattern in right (C) and middle (D) hepatic veins.

 


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  		Fig. 1C. —3-week-old male neonate with suspected but unconfirmed pyloric stenosis. Doppler sonograms of three hepatic veins reveal triphasic flow pattern in left hepatic vein by both anterior (A) and lateral (B) approaches and monophasic flow pattern in right (C) and middle (D) hepatic veins.

 


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  		Fig. 1D. —3-week-old male neonate with suspected but unconfirmed pyloric stenosis. Doppler sonograms of three hepatic veins reveal triphasic flow pattern in left hepatic vein by both anterior (A) and lateral (B) approaches and monophasic flow pattern in right (C) and middle (D) hepatic veins.

 


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  		Fig. 2A. —Patent ductus venosus in 3-day-old male neonate with mild hydrocephalus. Sagittal sonogram of liver shows patent ductus venosus (arrowheads) connecting left portal vein to inferior vena cava.

 


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  		Fig. 2B. —Patent ductus venosus in 3-day-old male neonate with mild hydrocephalus. Doppler sonogram of patent sinus venosus shows monophasic flow of higher velocity than that seen in C.

 


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  		Fig. 2C. —Patent ductus venosus in 3-day-old male neonate with mild hydrocephalus. Doppler sonogram of middle hepatic vein reveals triphasic flow pattern.

 


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  		Fig. 3. —Box plot of distribution of signal of flow in three hepatic veins revealed by Doppler sonography by percentile for age categories. ({blacksquare}) = right hepatic vein, ({blacktriangleup}) = middle hepatic vein, ({diamondsuit}) = left hepatic vein. Distribution of flow patterns of each hepatic vein around median value is indicated by bars for children in 25th and 75th percentiles and by whiskers for children in 10th and 90th percentiles. Note that monophasic flow is much more common in neonates.

 

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