Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
J Gastrointestin Liver Dis. 2012 Dec;21(4):407-12.
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.
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.
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.
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.
使用 CEUS 与 MRI、CT、DSA 或 US 比较，鉴定肝移植术后并发症。本研究评估 CEUS 是否可以确认初步诊断，甚至提供对治疗策略有意义的附加信息。
回顾性评估 23 例肝移植术后患者（年龄 1-72 岁）。当 US、CT、MRI 或数字减影血管造影（DSA）中出现模糊的诊断结果时，将 CEUS 用作附加诊断方法。所有患者均由经验丰富的检查者使用多频凸阵探头（1-5 MHz）进行基本 B 型扫描、彩色多普勒成像和 CEUS。在 SonoVue（R）推注后，存储多达 5 ml 的数字原始数据作为电影循环。
在所有 23 例患者中，均可使用 CEUS 确认其他成像方式中发现的病理特征和可疑诊断发现。在 12/23 例患者中，发现新的具有临床意义的发现。在 22 例患者中，CEUS 诊断在手术（4 例）、DSA（6 例）、随访 CEUS（6 例）、CT（2 例）、MRI（5 例）和结肠镜检查（1 例）中得到证实。在 4 例患者中发现门静脉或肝动脉狭窄，在 3 例患者中诊断为肝实质和肝血管正常灌注，1 例患者出现局部胆汁淤积，1 例患者出现肠出血。在 3 例患者中，能够明确诊断为良性肿瘤。
这些初步结果表明，CEUS 可以为肝移植术后早期并发症患者提供附加的、具有临床意义的信息。因此，在诊断过程中尽早应用似乎是有用的。
