Schroeder Tobias, Radtke Arnold, Debatin Jörg F, Malaga Massimo, Sotiropoulos Georgios C, Forsting Michael, Lang Hauke, Ruehm Stefan G
Department of Diagnostic & Interventional Radiology, University Hospital Essen, Germany.
Hepatogastroenterology. 2007 Jun;54(76):1176-80.
BACKGROUND/AIMS: To prospectively evaluate the feasibility of postoperative contrast enhanced Multi-detector-CT cholangiography (ceMDCT-CA) in living liver donors and transplant recipients.
Fifteen donors and 11 recipients of a right hepatic lobe underwent ceMDCT-CA. Six donors were admitted to exclude biliary leakage; 9 donors and 11 recipients were examined to exclude postoperative biliary obstruction. The examination protocol included the intravenous short-infusion of 100 mL of a biliary contrast agent. CT cholangiography data was acquired with a slice thickness of 1 mm. This scan was followed by examination of the upper abdomen in a venous phase. Data sets were evaluated quantitatively by measurement of the biliary opacification, and qualitatively on the basis of a scale ranging from 1 (non-diagnostic) to 4 (excellent). Opacification was correlated with postoperative serum bilirubin level.
CT data provided diagnostic delineation of the biliary tree in all 15 donors and seven of 11 recipients; in 4 recipients the degree of biliary opacification was non-diagnostic. Biliary opacification was generally higher in the donor collective. Four donors and 3 recipients presented a moderate focal biliary constriction without elevation of laboratory values. Six patients showed postoperative fluid collections suggestive of perihepatic biloma, however no biliary fistula could be visualized.
CeMDCT-CA represents a promising tool to non-invasively assess the postoperative biliary morphology in living liver donors and transplant recipients.
背景/目的：前瞻性评估术后对比增强多排CT胆管造影（ceMDCT-CA）在活体肝供体和移植受者中的可行性。
15名右肝叶供体和11名受者接受了ceMDCT-CA检查。6名供体入院以排除胆漏；9名供体和11名受者接受检查以排除术后胆管梗阻。检查方案包括静脉短时间输注100 mL胆管造影剂。以1 mm的层厚采集CT胆管造影数据。随后在静脉期对上腹部进行检查。通过测量胆管显影情况对数据集进行定量评估，并根据从1（非诊断性）到4（优秀）的评分进行定性评估。显影情况与术后血清胆红素水平相关。
CT数据在所有15名供体和11名受者中的7名中提供了胆管树的诊断性描绘；在4名受者中，胆管显影程度为非诊断性。供体组的胆管显影通常更高。4名供体和3名受者出现中度局灶性胆管狭窄，但实验室值无升高。6名患者显示术后有提示肝周胆汁瘤的积液，然而未发现胆瘘。
CeMDCT-CA是一种有前景的工具，可用于无创评估活体肝供体和移植受者术后的胆管形态。
