107 - A Systematic Review and Meta-analysis of the Pediatric Portal Vein Morphometry Using Ultrasound

Poster Board Number: 107
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Odd poster #s – first hour
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Abstract Body : Introduction and Objective
Ultrasound is the favourable imaging modality, particularly in assessing hepatic anatomy in the pediatric population. The morphometry of the hepatic portal vein is of clinical importance, particularly in pre-operative assessments, surgical management, and diagnoses of liver conditions. There is currently a paucity of knowledge regarding the morphometry of the portal vein in pediatric populations. Hence, this study aimed to apply principles of evidence-based anatomy to characterise the morphometry and dimensions of the healthy portal vein in pediatric patients.

Materials and Methods
The study was conducted following PRISMA guidelines and registered with PROSPERO. The MEDLINE, EMBASE, SCOPUS and Web of Science databases were searched. All studies reporting extractable data on diameter were included. The AQUA tool was used to assess the quality of the included studies. Data was statistically analysed using RStudio version 1.4.1106 (Vienna, Austria); subgroup analyses based on geographic location, sex, and study modality were conducted to identify possible contributors to heterogeneity.

Results
The search identified nine studies with a pooled sample of 918 subjects. Overall, the pooled mean diameter of the portal vein in children was 6.60mm (95% CI: 5.38 – 7.82). Subgroup analysis of regional differences identified studies in Africa (n = 4), Asia (n = 4) and North America (n = 1), with no significant difference between the diameters of the portal vein for Africa and Asia: 7.31mm (95% CI: 5.55-9.08) and 6.08mm (95% CI: 4.16 – 8.00), respectively. Additionally, there were no significant difference between sexes.

Conclusion, Significance/Implication
This is the first known study to report on a normal range of the pediatric portal vein diameter, using evidence-based principles. The results obtained from this study will help to establish standardised reference values of the healthy portal vein in the pediatric population as well as improve the understanding of its clinical significance. Such understanding has potential to inform diagnosis of liver pathologies, particularly portal hypertension in children, in that knowledge of the upper limit of the portal vein diameter can assist in distinguishing healthy from pathological states. Consequently, understanding of the above mentioned can guide future surgical interventions. Future studies intend to confirm the accuracy of the pooled mean diameter in the clinical setting.