Istituto di Clinica Pediatrica, Università di Pisa, Spedali di S. Chiara
Key words: Ultrasonography, Liver, Portal hypertension
Over the past two decades ultrasonography (US) have emerged as the principal imaging method for diagnostic examination of the liver and biliary tree. US is relatively not expensive and safe: the single major disadvantage is its dependence upon a skilled operator. US is useful in the diagnosis and management of children with portal hypertension: can dimostrate patency and diameter of the portal vein of the hepatic veins and of portocaval shunts. US can directely demonstrate varices in gastric fundus and in lower esophagus. The ratio between the thickness of lesser omentum and the diameter of the aorta is a predictive marker of the presence of esophageal varices. US can demonstrate the presence of cirrhosis by detecting nodularity of liver parenchima and can detect focal lesions of cystic or solid nature. In cholestatic disorders US demonstrate choledochal cyst and intra and/or extra hepatic bile duct dilatation related to mechanical obstruction. US is of little help in the diagnosis of neonatal cholestasis and biliary atresia.
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