Galanski M, Chavan A, Prokop M, Schaefer C, Harms J
Abteilung für Diagnostische Radiologie, Medizinische Hochschule Hannover, FRG.
Bildgebung. 1993 Jun;60(2):56-62.
Before transplantation, imaging procedures are mainly used to exclude factors which may serve as contraindications, render surgery difficult, or necessitate a modification of the operative technique. In addition, assessment of liver volume is necessary before segmental liver transplantation. Sonography or other cross-sectional imaging modalities are sufficient for these purposes. After transplantation, imaging is principally required in cases with suspected complications. Sonography, including Duplex and Doppler sonography, is an excellent first investigative modality for this purpose in addition to assessment of the clinical and biochemical parameters. Sonography can diagnose not only vascular complications but also biliary and infective complications; the former may also be a concealed cause of the latter. In unclear infections sonography often has to be supplemented by other modalities like CT. In equivocal cases a puncture is indicated. Invasive procedures are necessary in only selected cases, in particular when an intervention is under consideration. At present MR plays a limited role in the diagnostic workup as it rarely offers additional information except in very few cases. The early diagnosis of rejection cannot be reliably made by any of the imaging modalities and is essentially dependent on the biopsy.
移植前，成像程序主要用于排除可能作为禁忌症、使手术困难或需要修改手术技术的因素。此外，在进行节段性肝移植前，评估肝脏体积是必要的。超声检查或其他横断面成像方式足以满足这些目的。移植后，主要在怀疑有并发症的病例中需要进行成像检查。超声检查，包括双功和多普勒超声检查，除了评估临床和生化参数外，是用于此目的的出色的首选检查方式。超声检查不仅可以诊断血管并发症，还可以诊断胆道和感染性并发症；前者也可能是后者的潜在原因。在不明感染中，超声检查通常必须由CT等其他方式补充。在模棱两可的病例中，需要进行穿刺。仅在特定病例中才需要进行侵入性操作，特别是在考虑进行干预时。目前，磁共振成像在诊断检查中的作用有限，因为除了极少数情况外，它很少提供额外信息。任何成像方式都无法可靠地早期诊断排斥反应，其诊断主要依赖于活检。
