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Hepatic artery stenosis in liver transplantation: Imaging and interventional treatment.
MedLine Citation:
PMID:  21439751     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Main purpose of our study is to demonstrate the spectral and color Doppler ultrasonography (DUS) findings that would indicate hepatic artery stenosis (HAS) after liver transplantation and to report our single center results. Moreover we want to establish role and limits of the different imaging techniques in detecting HAS, proposing a non invasive diagnostic approach and to depict indications and feasibility of endovascular treatment in the single patient. MATERIALS AND METHODS: Our study consisted of 222 patients who underwent liver transplantation between January 1999 and December 2009. DUS findings were correlated with multidetector computed tomography angiography (MDCTA) and angiographic results. RESULTS: HAS occurred in 21 cases (9.5%). In all cases diagnosis was performed by DUS. MDCTA quantified stenosis and showed an overall picture of splanchnic vascularization. Based on DUS and MDCTA data integration, in 9 cases we adopted the "wait and see" strategy. Moreover in 12 cases treatment was considered necessary. For hepatic artery stenosis, use of DUS criteria resulted in a sensitivity of 100% (20/20), a specificity of 99.5% (201/202), a positive predictive value (PPV) of 95% (20/21), and negative predictive value (NPV) of 100% (201/201), and an overall accuracy of 99.5% (221/222). CONCLUSION: Our study underline the role of DUS in early diagnosis of HAS: repeated evaluation of both direct and indirect signs increases NPV and sensitivity of DUS.
Authors:
Pierluigi Rinaldi; Riccardo Inchingolo; Michela Giuliani; Carmine Di Stasi; Anna Maria De Gaetano; Giulia Maresca; Lorenzo Bonomo
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-23
Journal Detail:
Title:  European journal of radiology     Volume:  -     ISSN:  1872-7727     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome, Italy.
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