Identification of early complications following liver transplantation using contrast enhanced ultrasound (CEUS). First results.

AIM

Identification of complications following liver transplantation using CEUS in comparison with MRI, CT, DSA or US. The study evaluated whether CEUS could confirm the preliminary diagnosis or even provide additional information, relevant for the therapeutic strategy.

METHODS

Retrospective evaluation of 23 patients (age 1 - 72 years) following liver transplantation. CEUS was used as an additional diagnostic method when obscure diagnostic findings occurred in US, CT, MRI or digital subtraction angiography (DSA). Fundamental B-scan, Color Doppler imaging and CEUS were performed in all patients by an experienced examiner using a multifrequency convex transducer (1-5 MHz). After a bolus injection of up to 5 ml SonoVue (R) digital raw data was stored as cine-loops.

RESULTS

In all 23 patients, the pathological features and suspected diagnostic findings identified in the other imaging modalities could be confirmed using CEUS. In 12/23 patients, new clinically relevant findings were detected. In 22 patients, the diagnosis of CEUS was confirmed during surgery (4), DSA (6), follow-up CEUS (6), CT (2), MRI (5) and colonoscopy (1). In 4 patients, stenosis of the portal vein or hepatic artery were found, in 3 patients normal perfusion of the liver parenchyma and the hepatic vessels was diagnosed, 1 patient showed a local cholestasis and 1 patient intestinal bleeding. In 3 patients, a definite diagnosis of a benign tumor was possible.

CONCLUSION

These first results show that CEUS can provide additional, clinically relevant information in patients with early complications following liver transplantation. Thus, an early application within the diagnostic course seems useful.