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The role of Doppler US in segmental liver transplantation inchildrenEo H, Cheon J-E, Youn BJ, Jung AY, Kim WS, Kim I-O, Yeon KM,Seoul National University Children’s Hospital, Korea

Doppler US plays an important role in postoperative evaluation forchildren with segmental liver transplantation. Problems followingtransplantation include acute rejection, perihepatic fluid collections,and vascular and biliary complications. Focal fluid collections weremost often seen immediately after surgery along the cut surface of thegraft. Vascular complications included stenoses of the hepatic arteries,hepatic veins and portal veins. Radiologic interventions involved drain-age of fluid collections under US guidance, percutaneous cholangiog-raphy and angioplasty of vascular anastomoses. We present anatomy,common complications, and radiologic interventions in 47 childrenwho underwent segmental liver transplantation during the past 5 yearsfocused on US findings including Doppler spectral analysis.

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Neonatal abdominal cystic masses: Sonographic findings anddifferential diagnosisIm SA, Lim G-Y, Park CS, Kim BS, Kangnam St. Mary’s Hospital,Korea

With the increasing use of ultrasonography, abdominal cyst orcyst-like lesions are detected more frequently both before and afterbirth in neonate. We retrospectively reviewed sonographic findingsof pathologically or clinically confirmed neonatal abdominal cysticlesions. Most common neonatal abdominal cystic lesions were com-plicated or uncomplicated ovarian cysts. Ovarian cysts were com-plicated by hemorrhage or torsion. Choledochal cyst, duplicationcyst, mesenteric cyst and peritoneal cyst were included in congenitalcysts. One case of ileal duplication cyst resulted in ileoileal intus-susception. Cystic tumors included ovarian cystic teratoma, presa-cral cystic teratoma and cystic neuroblastoma and lymphangioma.Severe hydronephrosis, hydrometrocolpos, involuting adrenal andhepatic subcapsular hematoma and hepatic abscess may mimiccongenital cyst or cystic tumor. Because of the overlapping insonographic features of these cystic lesions, the diagnosis is usuallypresumptive and surgical exploration may be necessary to establisha definite diagnosis. However, consideration of the location of thelesion and familiarity with specific sonographic features may beuseful in differential diagnosis.

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Congenital intraabdominal cystic lesions: Correlation ofsonographic findings on prenatal US with postnatal USKim W-Y, Kwon TH, Ji EK, Kwak JY, Jung HK, CHA Hospital,Korea

We retrospectively reviewed prenatal and postnatal ultrasonographyand clinical charts of 14 patients with congenital intraabdominal cysticlesions confirmed by operation or follow-up US. The cystic lesions onprenatal sonography were located in RUQ (n � 5), RLQ (n � 3), LUQ(n � 3), epigastric region (n � 2) and LLQ (n � 1). The sonographicfindings of the simple cystic lesions on postnatal sonography werecompatible with the final diagnosis: in RUQ, duplication cysts (n � 2),hepatic cyst (n � 1) and upper calyceal dilataion of Rt. kidney (n � 1);in RLQ, abdominal testes with congenital testicular cyst (n � 1),ovarian cyst (n � 1) and ileal atresia (n � 1); in LUQ, cystic lique-faction of adrenal hemorrhage (n � 2); in epigastric region, duodenalatresia (n � 1) and proximal jejunal web (n � 1); in LLQ, ovarian cyst

(n � 1). Two lesions were multiseptated (n � 1) in RUQ or multicystic(n � 1) in LUQ on prenatal sonography, which was revealed as anovarian cyst (n � 1) and a multicystic dysplastic kidney (n � 1).

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Neonatal ovarian cyst: Therapeutic approachKessler A, Nagar H, Graif M, Fisher D, Halprin IHI, Tel AvivSouraski Medical Center, Israel; Shaare Zedek Medical Center,Jerusalem, Israel

Objectives: Neonatal ovarian cysts are reported in 82% of neonatalovaries. Spontaneous involution usually occurs. When it remains largerthan 4 cm complications of torsion can occur (42%).Methods: Twenty-three girls with ovarian cysts larger than 4 cm arepresented. Nine had surgery, and 14 underwent US guided aspiration.Five of the 23 cysts were simple, 18 were complex.Results: Fifteen cysts were aspirated. Eight underwent surgery, whichended in oophorectomy in six due to technical inability to separate thecyst from the ovary and due to gangrenous ovary. In two, cystectomywas performed; the ovary was saved. Of the 15 babies that wereaspirated, nine showed normal ovaries, two demonstrated a smallcalcified remnant, two, no visualization of the ovary, one lost to followup and one still in the process of follow up.Conclusions: Ultrasound guided aspiration of large neonatal cysts issafe, effective, repeatable and helps to preserve ovarian tissue. Whentorsion is suspected aspiration should be performed and surgeryavoided.

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Sonographic findings of the genital tract in boys with cysticfibrosisRathaus V, Werner M, Blau H, Meir Medical Center, Israel;Pulmonary Unit and Kathy and Lee Graub Cystic Fibrosis Center,Schneider Children’s Medical Center, Israel

This pictorial review illustrates the findings encountered in the sono-graphic examination of the male genital tract in children with cysticfibrosis. We illustrate the variability in the appearance and discuss thedifferences with findings in the adult male with cystic fibrosis. Therecognition of these features may play a key role in confirming thediagnosis of atypical cases. In addition, we found that ultrasonicexamination of the genital tract in male children with cystic fibrosiscould be normal, particularly in atypical cystic fibrosis with mildmutations. As this is a noninvasive examination, we recommend rou-tine ultrasonic evaluation, from the time of diagnosis, as well as regularfollow up every few years.

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Asymmetric ureteral jets as a marker of obstructivehydronephrosis in pediatric ageBessa-Junior J, Chammas MC, Cerri L, Buchpiguel C, Cerri G,Denes FT, Srougy M, Sao Paulo University, Medical School, Brazil

Objectives: Determine the diagnostic value of Doppler sonography ofthe ureteral jets (CDSG) to differentiate between obstructive and non-obstructive hydronephrosis in children.Methods: Forty-six patients with unilateral hydronephrosis were en-rolled (36 M–10 F),with age range varying from 3 to 167 months (mean81.9 mo). All patients underwent DTPA-diuretic renography DR) andevaluation of ureteral jets within a maximum of 2 weeks. Obstructionwas defined as T1/2, values greater than 20 min and as a unilateralabsence or diminished frequency less than 25% of contralateral side) ofthe ureteral jet. Statistical analysis was performed obtaining 2 � 2tables to analyze the measurements of accuracy.

P272 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006