Wechsler R J, Munoz S J, Needleman L, Kurtz A B, Miller C L, Yang S L, Maddrey W C, Jarrell B E
Radiology. 1987 Oct;165(1):57-60. doi: 10.1148/radiology.165.1.3306790.
A low-attenuation region around the peripheral portal tracts (periportal collar) was noted on 13 of 43 computed tomographic studies obtained in 17 patients who had undergone 20 orthotopic liver transplantations. This region was then correlated with acute liver transplant rejection. The periportal collar as a sign of rejection has a sensitivity of 1.0, a specificity of 0.86, a negative predictive value of 1.0, and a positive predictive value of 0.62. This sign corresponds histopathologically with the lymphocytic portal infiltration that occurs during acute liver transplant rejection. Though viral hepatitis and nonspecific portal triad edema can also result in a periportal collar, acute liver rejection is strongly suggested when this sign is seen after liver transplantation. Early diagnosis and confirmation of rejection permit faster and more appropriate clinical intervention.
在接受20次原位肝移植的17例患者所进行的43项计算机断层扫描研究中，有13项发现肝门周围区域（门周套圈）存在低密度区。然后将该区域与急性肝移植排斥反应相关联。作为排斥反应征象的门周套圈，其敏感性为1.0，特异性为0.86，阴性预测值为1.0，阳性预测值为0.62。该征象在组织病理学上与急性肝移植排斥反应期间发生的淋巴细胞性门脉浸润相对应。虽然病毒性肝炎和非特异性门三联征水肿也可导致门周套圈，但肝移植后出现此征象强烈提示急性肝排斥反应。早期诊断和确认排斥反应可使临床干预更快、更恰当。
