Journal of Korean Society of Medical Ultrasound 2002;21(1): 9-14.
Usefulness of Preoperative Doppler Ultrasonography in Liver Transplant Recipients.
Jee Hee Kang, Won Jae Lee, Seung Hoon Kim, Soon Jin Lee, Hyo Keun Lim, Jae Hoon Lim
Department of Radiology and Gastrointestinal Center, Samsung Medical Center Sungkyunkwan University School of Medicinem Korea. wjlee@smc.samsung.co.kr
  Published online: March 1, 2002.
ABSTRACT
PURPOSE: To evaluate the usefulness of Doppler ultrasound (DUS) as a preoperative radiologic examination for the liver transplant recipients and to compare its diagnostic efficacy with computed tomography (CT). MATERIALS AND METHODS: Among one hundred three liver transplant recipients, fifty three subjects who underwent both DUS and triphasic helical CT preoperatively were included in this study (age range: 19 -62 yrs, mean age: 43 yrs, M:F=4.3:1). Retrospective comparison between DUS and CT scan was performed using the following parameters: (1) the presence or absence of hepatic tumor and portal vein thrombosis, (2) the patency of the main portal vein (PV) and hepatic vein (HV), (3) the size of the proper hepatic artery and main portal vein, (4) the flow velocity and direction of hepatic vasculatures (hepatic artery, portal vein, and hepatic vein), (5) the diagnosis of hepatic parenchymal disease, and (6) the extrahepatic manifestations of hepatic parenchymal disease. However, this study was particularly focused on whether DUS could offer additional informations over CT. RESULTS: Among seventeen surgically confirmed hepatic tumors (15 hepatocellular carcinomas and two cholangiocarcinomas), 11 hepatocellular carcinomas (85%) and two cholangiocarcinomas (100%) were detected on CT scan while only six hepatocellular carcinomas (46%) and one cholangiocarcinoma (50%) were detected on DUS. For the evaluation of portal vein thrombosis, 12 cases with thrombi on CT scan and seven thrombi on DUS were detected, respectively. Twenty percent of the main PV and fifteen percent of HV were not clearly delineated on DUS whose CT scan demonstrated the patent PV and HV in these cases. The size of the proper hepatic artery and main portal vein was measurable on CT scan in all cases while 89% of the proper hepatic artery and 94% of the main PV were measurable on DUS. Doppler waveforms of the hepatic artery and portal vein were obtained in 94% and 89% of all patients, respectively, and the direction of all portal veins was all he-patopetal. There are no difference between DUS and CT in the diagnosis of hepatic parenchymal diseases and their extrahepatic manifestations. CONCLUSION: In the preoperative radiologic evaluation of liver transplant recipient, CT turned out to be superior than DUS in all parameters described above. DUS alone offers additional information on hepatic blood flow. Therefore, DUS does not appear to be essential in the preoperative evaluation of liver transplant recipient if pre-operative CT scan is performed.
Keywords: Liver; transplantation; Liver; CT; Liver, US
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