Initial experience with contrast-enhanced ultrasound in the first week after liver transplantation in children: a useful adjunct to Doppler ultrasound
PEDIATRIC RADIOLOGY, vol.51, no.2, pp.248-256, 2021 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 51 Issue: 2
- Publication Date: 2021
- Doi Number: 10.1007/s00247-020-04811-0
- Journal Name: PEDIATRIC RADIOLOGY
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
- Page Numbers: pp.248-256
- Bursa Uludag University Affiliated: No
Abstract
Background Doppler US is the primary screening for post-liver transplant vascular complications, but indeterminate findings require further imaging. Objective To evaluate whether contrast-enhanced US improves diagnostic assessment of vascular complications suspected by Doppler US. Materials and methods We retrospectively reviewed Doppler US and contrast-enhanced US studies obtained in the first week following liver transplant. Doppler US was performed twice daily for the first 5 postoperative days, and CEUS in the first postoperative day and when vascular complications were suspected. We correlated Doppler US and CEUS with surgical findings, and clinical and imaging follow-up. We evaluated Doppler US and CEUS quality in demonstrating the main hepatic artery (HA) at the porta hepatis as follows: Grade 0 = not seen, Grade 1 = only segments, Grade 2 = entire main HA, and Grade 3 = entire main HA to the intrahepatic branching. We used a Wilcoxon signed rank test to test the difference between Doppler US and CEUS methods. Results Twenty-nine children (15 girls, 14 boys) were identified, with median age 2.2 years (range 0.5-17.6 years). The most common transplant indication was biliary atresia (n=13). There was significantly (P<0.0001) improved main HA visualization with CEUS. In five children, CEUS was performed to evaluate suspected vascular complications; CEUS confirmed normal vascularity in two. CEUS demonstrated portal vein thrombosis (n=2) and main HA thrombosis (n=1), confirmed at surgery. In one child the main HA thrombosis was missed; marked HA narrowing was seen retrospectively on CEUS. Conclusion Immediately following liver transplantation, CEUS improves main HA visualization and diagnostic assessment of vascular complications.