Westra S J, Zaninović A C, Hall T R, Busuttil R W, Kangarloo H, Boechat M I
Department of Radiological Sciences, University of California, School of Medicine, Los Angeles 90024-1721.
Radiographics. 1993 Sep;13(5):1081-99. doi: 10.1148/radiographics.13.5.8210591.
Liver transplantation is an accepted and successful mode of treatment for pediatric end-stage liver disease. On the basis of a review of 229 liver transplantations in 185 children, the authors describe the imaging findings of the preoperative evaluation, the uncomplicated transplantation, various postoperative complications, and the suggested percutaneous treatment of some of these complications. The most frequent indications for liver transplantation encountered in this review were biliary atresia (52%), acute fulminant hepatic failure (11%), alpha 1-antitrypsin deficiency (9%), cryptogenic cirrhosis (6%), and chronic active hepatitis (4%). (The remaining 18% were various rare indications, representing < 4% each.) Routine Doppler ultrasound is the modality of choice for the screening of postoperative complications, supplemented with computed tomography, hepatobiliary scintigraphy, and cholangiography or angiography as needed. Familiarity with the normal graft appearance, as influenced by various surgical and technical factors, and knowledge of the underlying condition of the patient and the clinical course of postoperative complications are crucial for a correct interpretation of the findings from imaging studies.
肝移植是治疗小儿终末期肝病公认且成功的治疗方式。基于对185名儿童进行的229例肝移植的回顾，作者描述了术前评估、单纯移植、各种术后并发症的影像学表现，以及针对其中一些并发症建议的经皮治疗方法。本次回顾中遇到的肝移植最常见适应证为胆道闭锁（52%）、急性暴发性肝衰竭（11%）、α1-抗胰蛋白酶缺乏症（9%）、隐源性肝硬化（6%）和慢性活动性肝炎（4%）。（其余18%为各种罕见适应证，每种占比均<4%。）常规多普勒超声是筛查术后并发症的首选方式，必要时辅以计算机断层扫描、肝胆闪烁显像以及胆管造影或血管造影。熟悉受各种手术和技术因素影响的正常移植物表现，了解患者的基础病情以及术后并发症的临床过程，对于正确解读影像学研究结果至关重要。
