超声检查能否区分肝移植术后吻合口和非吻合口胆道狭窄：单中心经验。

Can ultrasonography differentiate anastomotic and non-anastomotic biliary strictures after orthotopic liver transplantation- a single-center experience.

机构信息

Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, 510630, PR China.

Department of Traditional Chinese Medicine, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, 510630, PR China.

出版信息

Eur J Radiol. 2021 Jan;134:109416. doi: 10.1016/j.ejrad.2020.109416. Epub 2020 Nov 27.

DOI:10.1016/j.ejrad.2020.109416

PMID:33249391

Abstract

PURPOSE

To evaluate the role of ultrasonography (US) in differentiating anastomotic biliary strictures (AS) and non-anastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT).

METHOD

This retrospective study included 1259 OLT recipients between 2005-2018. Seventy-six with anastomotic strictures (AS) and 103 with non-anastomotic strictures (NAS) were analyzed. The reference standard was cholangiography. The sensitivity, specificity, accuracy of US was evaluated.

RESULTS

There were significant differences between AS and NAS groups (p < 0.001) for skipped and irregular dilatation of intrahepatic bile duct and visualization of hilar biliary lumen. The better US imaging feature for NAS was poorly visualized and non- visible hilar bile duct luminal contour. The sensitivity, specificity and accuracy were 94.2 %, 84.2 % and 88.9 % respectively. Combined two predictors greatly increased the specificity to 93.4 % while diminished its sensitivity and accuracy.

CONCLUSION

US is useful and efficient to differentiate AS and NAS after OLT.

摘要

目的

评估超声（US）在鉴别肝移植（OLT）后吻合口胆道狭窄（AS）和非吻合口胆道狭窄（NAS）中的作用。

方法

本回顾性研究纳入了 2005 年至 2018 年间的 1259 例 OLT 受者。分析了 76 例吻合口狭窄（AS）和 103 例非吻合口狭窄（NAS）患者。参考标准为胆管造影。评估了 US 的敏感性、特异性和准确性。

结果

AS 组和 NAS 组在肝内胆管跳跃性和不规则性扩张以及肝门胆管内腔可视化方面存在显著差异（p < 0.001）。NAS 较好的 US 成像特征是肝门胆管腔轮廓显示不佳且不可见。其敏感性、特异性和准确性分别为 94.2%、84.2%和 88.9%。联合两个预测因素可显著提高特异性（93.4%），但降低了敏感性和准确性。