| Hepatic outflow obstruction at middle hepatic vein tributaries or inferior right hepatic veins after living donor liver transplantation with modified right lobe graft: comparison of CT and Doppler ultrasound. | |
MedLine Citation:
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PMID: 19696288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of our study was to compare CT and Doppler ultrasound in the diagnosis of hepatic outflow obstruction at the middle hepatic vein (MHV) tributaries and inferior right hepatic veins (RHVs) after living donor liver transplantation (LDLT) with modified right lobe grafts. MATERIALS AND METHODS: Thirty-seven venographies were performed in 36 patients after LDLT with modified right lobe grafts, evaluating 51 MHV tributaries and 25 inferior RHVs. They were classified as obstructed or nonobstructed. On Doppler ultrasound or CT, flow patterns of the MHV tributaries and inferior RHVs or the relative parenchymal attenuation, enhancement, and opacification of these veins were evaluated for the diagnosis of hepatic outflow obstruction. McNemar tests were performed to compare the diagnostic values of Doppler ultrasound and CT. RESULTS: On the basis of hepatic venography, 33 MHV tributaries were categorized as obstructed and 18 as nonobstructed, and 16 inferior RHVs were categorized as obstructed and nine as nonobstructed. For the diagnosis of MHV tributary obstruction, Doppler ultrasound was more sensitive and accurate, although less specific, than CT (97% vs 39%, respectively, p < 0.001; 86% vs 61%, p = 0.0209; 67% vs 100%, p = 0.0412). Similarly, Doppler ultrasound was more sensitive (94% vs 31%, respectively) and accurate (84% vs 56%) than CT, although less specific (67% vs 100%), for the diagnosis of inferior RHV obstruction, with a statistical significance only for sensitivity (p = 0.002, 0.092, and 0.248, respectively). CONCLUSION: Doppler ultrasound is more sensitive and accurate than CT for the detection of obstruction at the MHV tributaries and inferior RHVs in patients after LDLT using modified right lobe grafts. Although current CT criteria produce high specificity and may reduce unnecessary invasive venographies, optimal CT criteria with acceptable sensitivity should be reestablished. |
Authors:
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Hye Jeon Hwang; Kyoung Won Kim; Woo Kyoung Jeong; So Yeon Kim; Gi-Won Song; Shin Hwang; Sung-Gyu Lee |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 193 ISSN: 1546-3141 ISO Abbreviation: - Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-21 Completed Date: 2009-09-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 745-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-ku, Seoul 138-736, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Budd-Chiari Syndrome / etiology, radiography*, ultrasonography* Collateral Circulation Female Hemodynamics Hepatic Veins * / radiography, ultrasonography Humans Image Interpretation, Computer-Assisted Liver Transplantation * Living Donors Male Middle Aged Phlebography Retrospective Studies Sensitivity and Specificity Tomography, X-Ray Computed * Ultrasonography, Doppler * |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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