Flow dynamics in the liver is altered in different hepatobiliary and cardiac pathologies, causing changes in hepatic vasculatures sizes and flow pattern changes which can be assessed by ultrasound (USG) study. Before one can use these measurements and observations to diagnose pathologies, a clear grasp of normality is crucial. In the field of pediatrics, this is particularly challenging as the normal range of measurements may change with age, weight, height, gender and race of children. Taking hepatic veno-occlusive disease as an example, current literature is conflicting regarding whether sonographic findings show consistent association with the disease. Sonographic findings therefore now have limited role in contributing to the diagnosis. This may be related to the lack of a robust age corrected normal range of measurement for reference. Existing literature shows that the normal portal vein diameter varies with age, weight and height and possibly gender. Literature for normal measurements of hepatic vein and hepatic artery in children is lacking. In this study, the investigators aim to conduct a prospective, cross-section observational study to establish the normal measurements ranges of hepatic vein, hepatic artery and portal vein in healthy children in the investigators' locality. Flow patterns, including qualitative assessment and quantitative measurements of resistive index and flow velocities will also be assessed. These age corrected normal measurements will be very helpful in the diagnosis and follow-up of hepatobiliary and cardiac pathologies associated with alterations in dynamics of hepatic circulation.
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Hepatic veins diameter (in mm) measured by grey scale ultrasound at 1 - 2 cm from confluence with inferior vena cava
Timeframe: Baseline
Hepatic veins Doppler assessment of flow direction (towards or away from inferior vena cava)
Timeframe: Baseline
Hepatic veins Doppler assessment of flow pulsatility (yes or no)
Timeframe: Baseline
Hepatic veins Doppler assessment of flow phasicity (monophasic, biphasic or triphasic)
Timeframe: Baseline
Hepatic veins Quantitative Doppler measurement of maximum flow rate (cm/s)
Timeframe: Baseline
Hepatic veins Quantitative Doppler measurement of minimum flow rate (cm/s)
Timeframe: Baseline
Hepatic veins Quantitative Doppler measurement of pulsatility index (only if pulsatility is present)
Timeframe: Baseline
Hepatic artery diameter (in mm) measured by grey scale ultrasound at liver hilum
Timeframe: Baseline
Hepatic artery Doppler assessment of flow direction (hepatofugal or hepatopetal)
Timeframe: Baseline
Hepatic artery Doppler assessment of flow pulsatility (yes or no)
Timeframe: Baseline
Hepatic artery Doppler assessment of flow phasicity (monophasic, biphasic or triphasic)
Timeframe: Baseline
Hepatic artery quantitative Doppler measurement of peak systolic velocity (cm/s)
Timeframe: Baseline
Hepatic artery quantitative Doppler measurement of end diastolic velocity (cm/s)
Timeframe: Baseline
Hepatic artery quantitative Doppler measurement of pulsatility index
Timeframe: Baseline
Hepatic artery quantitative Doppler measurement of resistive index
Timeframe: Baseline
Hepatic artery quantitative Doppler measurement of flow volume (ml/s) (measured if feasible)
Timeframe: Baseline
Portal vein diameter (in mm) measured by grey scale ultrasound at liver hilum
Timeframe: Baseline
Portal vein Doppler assessment of flow direction (hepatopetal or hepatofugal)
Timeframe: Baseline
Portal vein Doppler assessment of flow pulsatility (yes or no)
Timeframe: Baseline
Portal vein Doppler assessment of flow phasicity (monophasic, biphasic or triphasic)
Timeframe: Baseline
Portal vein quantitative Doppler measurement of maximum flow rate (cm/s)
Timeframe: Baseline
Portal vein quantitative Doppler measurement of minimum flow rate (cm/s)
Timeframe: Baseline
Portal vein quantitative Doppler measurement of pulsatility index (only if pulsatility is present)
Timeframe: Baseline
Portal vein quantitative Doppler measurement of flow volume (ml/s)
Timeframe: Baseline