Galanski M, Ringe B
Abteilung Diagnostische Radiologie I, Medizinische Hochschule Hannover.
Radiologe. 1992 May;32(5):241-7.
The main function of imaging procedures before liver transplantation is the exclusion of factors that may either constitute contraindications to surgery or necessitate a modification of the operation technique. Ultrasound and MRI are the modalities best suited for this purpose. After transplantation, imaging procedures are required mainly for diagnosis of and differentiation, in particular, between vascular and biliary complications, rejection, and infection, since these postoperative complications very often cannot be reliably differentiated on the basis of clinical and laboratory parameters alone. As vascular disturbances can vary widely in their presentation and can mimic other complications, duplex Doppler sonography plays a dominant role in clarification of the perfusion status of the graft. If infection is suspected, ultrasound generally has to be supplemented by other imaging procedures such as CT or MRI; if these techniques reveal suggestive lesions, a fine-needle aspiration is mandatory in most cases. Invasive procedures such as angiography or PTC are now applied only in selected cases, especially if an intervention is contemplated. Rejection cannot be reliably diagnosed by any of the imaging techniques and still requires biopsy.
肝移植前成像检查的主要功能是排除可能构成手术禁忌或需要改变手术技术的因素。超声和磁共振成像（MRI）是最适合此目的的检查方式。移植后，成像检查主要用于诊断和鉴别，特别是血管和胆道并发症、排斥反应及感染，因为这些术后并发症往往无法仅根据临床和实验室参数可靠地区分。由于血管紊乱的表现差异很大且可模拟其他并发症，双功多普勒超声在明确移植物灌注状态方面起主导作用。如果怀疑有感染，通常必须用其他成像检查如CT或MRI来补充超声检查；如果这些技术发现有提示性病变，大多数情况下必须进行细针穿刺抽吸活检。诸如血管造影或经皮肝穿刺胆管造影（PTC）等侵入性检查现在仅在特定情况下应用，特别是考虑进行干预时。任何成像技术都不能可靠地诊断排斥反应，仍需要进行活检。
