Han Taewon, Jeong Woo Kyoung, Shin Jaeseung, Cha Dong Ik, Gu Kyowon, Rhu Jinsoo, Kim Jong Man, Choi Gyu-Seong
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ultrasonography. 2024 Nov;43(6):469-477. doi: 10.14366/usg.24114. Epub 2024 Aug 27.
This study aimed to determine whether micro-flow imaging (MFI) offers diagnostic performance comparable to that of contrast-enhanced ultrasonography (CEUS) in detecting segmental congestion among patients undergoing living donor liver transplantation (LDLT).
Data from 63 patients who underwent LDLT between May and December 2022 were retrospectively analyzed. MFI and CEUS data collected on the first postoperative day were quantified. Segmental congestion was assessed based on imaging findings and laboratory data, including liver enzymes and total bilirubin levels. The reference standard was a postoperative contrast-enhanced computed tomography scan performed within 2 weeks of surgery. Additionally, a subgroup analysis examined patients who underwent reconstruction of the middle hepatic vein territory.
The sensitivity and specificity of MFI were 73.9% and 67.5%, respectively. In comparison, CEUS demonstrated a sensitivity of 78.3% and a specificity of 75.0%. These findings suggest comparable diagnostic performance, with no significant differences in sensitivity (P=0.655) or specificity (P=0.257) between the two modalities. Additionally, early postoperative laboratory values did not show significant differences between patients with and without congestion. The subgroup analysis also indicated similar diagnostic performance between MFI and CEUS.
MFI without contrast enhancement yielded results comparable to those of CEUS in detecting segmental congestion after LDLT. Therefore, MFI may be considered a viable alternative to CEUS.
本研究旨在确定微流成像（MFI）在检测活体肝移植（LDLT）患者节段性充血方面的诊断性能是否与超声造影（CEUS）相当。
回顾性分析了2022年5月至12月期间接受LDLT的63例患者的数据。对术后第一天收集的MFI和CEUS数据进行量化。根据影像学表现和实验室数据（包括肝酶和总胆红素水平）评估节段性充血情况。参考标准为术后2周内进行的术后增强CT扫描。此外，亚组分析考察了接受肝中静脉区域重建的患者。
MFI的敏感性和特异性分别为73.9%和67.5%。相比之下，CEUS的敏感性为78.3%，特异性为75.0%。这些结果表明两种方法的诊断性能相当，两种模式在敏感性（P=0.655）或特异性（P=0.257）方面无显著差异。此外，术后早期实验室值在有充血和无充血的患者之间没有显示出显著差异。亚组分析也表明MFI和CEUS之间的诊断性能相似。
无造影剂增强的MFI在检测LDLT术后节段性充血方面的结果与CEUS相当。因此，MFI可被视为CEUS的一种可行替代方法。
