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在使用改良右叶移植物的活体供肝移植术中使用高频探头进行术中超声检查。

Intraoperative sonography using high-frequency transducer during living Donor liver transplantation with modified right-lobe graft.

作者信息

Kim Jin Sil, Kim Kyoung Won, Choi Eun Sun, Song Gi-Won

机构信息

Department of Radiology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Ultrasonography. 2025 Jul;44(4):294-303. doi: 10.14366/usg.25047. Epub 2025 May 6.

DOI:10.14366/usg.25047
PMID:40518674
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12242362/
Abstract

This study highlights the role of intraoperative sonography (IOS) using a high-frequency transducer in living donor liver transplantation (LDLT) with modified right-lobe grafts. IOS is pivotal for the real-time assessment of vascular patency and anastomotic integrity, providing crucial insights into hepatic artery, portal vein, and hepatic vein configurations. The technique's high spatial resolution allows for the early detection of potential vascular complications, which are significant predictors of postoperative outcomes. Through detailed illustrations of vascular anastomoses and hemodynamics, this article discusses technical and anatomical considerations of IOS and demonstrates its effectiveness in screening and managing vascular complications in LDLT, thereby enhancing surgical precision and patient safety.

摘要

本研究强调了在采用改良右叶移植物的活体肝移植（LDLT）中使用高频探头进行术中超声检查（IOS）的作用。IOS对于实时评估血管通畅性和吻合完整性至关重要，能为肝动脉、门静脉和肝静脉的形态提供关键见解。该技术的高空间分辨率有助于早期发现潜在的血管并发症，而这些并发症是术后结果的重要预测指标。通过对血管吻合和血流动力学的详细图示，本文讨论了IOS的技术和解剖学考量，并展示了其在筛查和处理LDLT血管并发症方面的有效性，从而提高手术精度和患者安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/72bbe13dd75c/usg-25047f9.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/2b8ed75cc745/usg-25047f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/72bbe13dd75c/usg-25047f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/9a6ca3ea7c02/usg-25047f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/cb1bdc220764/usg-25047f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/9755c866c135/usg-25047f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/c2a858ac5fbb/usg-25047f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/2f5a909aad0d/usg-25047f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/2b8ed75cc745/usg-25047f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/12242362/72bbe13dd75c/usg-25047f9.jpg

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本文引用的文献

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Diagnostic Performance for Hepatic Artery Occlusion After Liver Transplantation: Computed Tomography Angiography Versus Contrast-Enhanced Ultrasound.肝移植术后肝动脉闭塞的诊断性能：计算机断层血管造影与对比增强超声。
Liver Transpl. 2019 Nov;25(11):1651-1660. doi: 10.1002/lt.25588. Epub 2019 Jul 19.
2
Hepatic Artery Occlusion after Liver Transplantation in Patients with Doppler Ultrasound Abnormality: Increasing Sensitivity of Contrast-Enhanced Ultrasound Diagnosis.移植肝动脉闭塞症：超声造影在多普勒超声异常患者中的诊断价值。
Korean J Radiol. 2019 Mar;20(3):459-468. doi: 10.3348/kjr.2018.0464.
3
Doppler ultrasonography in liver transplant recipients with hepatic artery dissection: association of Doppler abnormalities with disease severity.
肝动脉夹层肝移植受者的多普勒超声检查：多普勒异常与疾病严重程度的关联
Br J Radiol. 2018 Jul;91(1088):20180182. doi: 10.1259/bjr.20180182. Epub 2018 May 23.
4
N-butyl-2 cyanoacrylate (NBCA) embolus in the graft portal vein after portosystemic collateral embolization in liver transplantation recipient: what is the clinical significance?肝移植受者门体分流栓塞后门静脉移植物内的正丁基-2-氰基丙烯酸酯（NBCA）栓子：临床意义是什么？
Acta Radiol. 2017 Nov;58(11):1326-1333. doi: 10.1177/0284185117693460. Epub 2017 Feb 22.
5
Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study.成人对成人活体肝移植后的并发症与死亡率：一项回顾性队列研究。
Ann Med Surg (Lond). 2015 Apr 25;4(2):162-71. doi: 10.1016/j.amsu.2015.04.021. eCollection 2015 Jun.
6
Influence of preoperative portal hypertension and graft size on portal blood flow velocity in recipient after living donor liver transplantation with right-lobe graft.右半肝供肝活体肝移植术后受体门静脉血流速度与术前门静脉高压及供肝体积的关系
AJR Am J Roentgenol. 2010 Feb;194(2):W165-70. doi: 10.2214/AJR.09.2591.
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Evaluation of the hepatic artery anastomosis by intraoperative sonography with high-frequency transducer in right-lobe graft living donor liver transplantation.
J Clin Ultrasound. 2010 Jan;38(1):10-6. doi: 10.1002/jcu.20628.
8
Routine intraoperative Doppler sonography in the evaluation of complications after living-related donor liver transplantation.活体亲属供肝移植术后并发症评估中的术中常规多普勒超声检查
J Clin Ultrasound. 2007 Nov-Dec;35(9):483-90. doi: 10.1002/jcu.20384.
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Doppler sonographic abnormalities suggestive of venous congestion in the right lobe graft of living donor liver transplant recipients.多谱勒超声检查异常提示活体供肝移植受者右叶移植肝存在静脉淤血。
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