Betancur V, Zughul R, Ivanovic A, Madrazo B L, Castillo P, Casillas J, Alessandrino F
Leonard M. Miller School of Medicine, University of Miami, FL, USA.
Department of Radiology, Jackson Memorial Hospital, Miami, FL, USA.
Clin Radiol. 2023 Nov;78(11):861-871. doi: 10.1016/j.crad.2023.08.009. Epub 2023 Aug 30.
Pancreatic transplantation is an established treatment for patients with type 1 diabetes patients and select type 2 diabetes patients, with excellent survival rates as graft health is evaluated through regular imaging and early detection of complications. Amongst the various imaging methods that may aid in diagnosis of pancreatic transplant complications, ultrasound is a widely available, quick, portable, and cost-effective technique, often used as the sole method to assess for pancreatic transplant complications. When assessing a patient with a pancreatic transplant, the radiologist should be methodical in assessing the vasculature, the pancreatic parenchyma, and the peripancreatic regions. Complications can be categorised based on time from transplant and type of complications, and include vascular, parenchymal, and enteric/anastomotic complications. Doppler has a major role in the diagnosis of vascular complications including arterial and venous thrombosis, arterial stenosis, pseudoaneurysms, and haematomas. Pancreatic complications include rejections and pancreatitis, and are often diagnosed through a combination of clinical, laboratory, and imaging findings, such as pancreatic heterogeneity or the presence of pancreatic pseudocysts. Enteric/anastomotic complications include leaks and bowel obstructions, and may require cross-sectional imaging in addition to ultrasound. This review covers the most common and high-impact vascular, parenchymal, and enteric/anastomotic complications that should be considered in every radiologist's search pattern when assessing a pancreatic graft, as well as their respective postoperative timeframes.
胰腺移植是1型糖尿病患者和部分2型糖尿病患者的既定治疗方法，由于通过定期成像和并发症的早期检测来评估移植物健康状况，其生存率很高。在有助于诊断胰腺移植并发症的各种成像方法中，超声是一种广泛可用、快速、便携且经济高效的技术，常被用作评估胰腺移植并发症的唯一方法。在评估胰腺移植患者时，放射科医生应系统地评估血管系统、胰腺实质和胰腺周围区域。并发症可根据移植后的时间和并发症类型进行分类，包括血管性、实质性和肠道/吻合口并发症。多普勒在诊断血管并发症（包括动脉和静脉血栓形成、动脉狭窄、假性动脉瘤和血肿）中起主要作用。胰腺并发症包括排斥反应和胰腺炎，通常通过临床、实验室和影像学检查结果（如胰腺异质性或胰腺假性囊肿的存在）相结合来诊断。肠道/吻合口并发症包括渗漏和肠梗阻，除超声检查外，可能还需要进行断层成像。本综述涵盖了在评估胰腺移植物时每位放射科医生的检查模式中应考虑的最常见且影响较大的血管性、实质性和肠道/吻合口并发症，以及它们各自的术后时间范围。
