Title: Ischemic damage of hepatic parenchema after liver transplantation: the value of multi-slice CT in diagnosis and etiologic analysis
Abstract: Objective To discuss the CT features of graft ischemic damages after liver transplantation and estimate the value of multi-slice CT in the etiological analysis. Methods There were 43 patients who presented hepatic artery or portal vein stenosis or thrombosis in dynamic enhancement CT exams. Among them, 23 received hepatic arteriography and indirect portography; 17 had graft ischemia or infarction which was confirmed by histopathology or follow-up examinations. We retrospectively analyzed the CT features of hepatic ischemia and infarction after liver transplantation, and estimated the value of CT angiography (CTA) in etiological diagnosis. Results All the ischemia and infarction areas of the graft distributed in the subcapsular parts, which demonstrated patchy or wedge-shaped hypo-attenuation on plain CT scan, with lower or none enhancement on contrast-enhanced CT scan. The hepatic artery or portal vein branches in those areas were lessened, thinned or non-enhanced. CTA demonstrated hepatic artery or portal vein complications in all these cases, including hepatic artery complication (70.59%), portal vein complication (5.88%), and hepatic artery complication complicated with portal vein complication (23.53%). The distribution of ischemic damages related to the site of blood vessel lesions. Compared to DSA, the sensitivity, specificity, predictive value of positive cases (PVP) and predictive value of negative cases (PVN) of CTA in diagnosis of main trunk of hepatic artery and portal vein lesions (stenosis and thrombosis) were all 100%. The sensitivity, specificity, PVP and PVN of CTA in diagnosis of hepatic artery branches stenosis and thrombosis were 100%, 80.00%, 72.73% and 100%, respectively. Conclusion Combined CTA with dynamic enhancement CT examination not only could present the hepatic ischemic damages, but also could accurately demonstrate the state of blood vessel lesions which lead to hepatic ischemia or infarction. Hepatic artery complication is the main reason for hepatic ischemia.
Publication Year: 2007
Publication Date: 2007-01-01
Language: en
Type: article
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