CEUS: A new imaging approach for postoperative vascular complications after right-lobe LDLT

Abstract

CEUS may be a new approach for early diagnosis of postoperative vascular complications after RLDLT, and it can be performed at the bedside.

Contrast-enhanced Ultrasound for Liver Imaging: Recent Advances

“…Disappearance or abnormal blood flow in the intrahepatic branches (corresponding to the tardus-parvus flow pattern) of the hepatic artery and its disappearance at the porta hepatis are the main sign of hepatic artery thrombosis at Doppler US. Nevertheless, the sensitivity of Doppler US in the identification of thrombosis has been reported to be about 60-91% [138,139]. To the contrary, the sensitivity and specificity of CEUS was reported as very good in this situation in a Norwegian series [140].…”

“…When compared with Doppler US, CEUS provides only a slight advantage because the portal vein is well visualized in almost all patients after OLT with conventional Doppler US [138,142]. Caliber mismatch between the donor and the recipient veins is very common and the diameter of both vessels may be more confidently determined through the injection of USCA [138] but this assessment has limited or even no clinical impact at all.…”

“…The main benefit of CEUS may be probably related to right-lobe living donor transplantation, because tiny tributaries of the middle hepatic vein may be easier detectable with CEUS [138] but a generalized use of CEUS in this setting has no role.…”

Sonografie nach Lebertransplantation

“…Die Kombination mit der systolischen Spitzengeschwindigkeit führte zu einer Reduktion der Genauigkeit [35]. Bei unklarer Konstellation kann eine kontrastmittelverstärkte Sonografie zur Klärung der Diagnose beitragen [25,31,39,40]. Allerdings scheint der diagnostische Zugewinn einer kontrastmittelunterstützte Doppler-Sonografie gering, wenn bereits eine klassische Tardus-parvus-Form vorliegt [31].…”

Contrast‐enhanced sonography for screening of vascular complication in recipients following living donor liver transplantation

“…As a noninvasive examination, Doppler ultrasound (US) plays an important role in screening for postoperative vascular complications, but Doppler US is frequently labor-intensive especially in recipients of living donor liver transplantation (LDLT) with small hepatic vessel size and multiple anastomoses and suffers from frequent false-positive results. [1][2][3] Using contrast-enhanced US (CEUS) with microbubbles that act as blood pool tracers, the limitations of Doppler US can be overcome and parenchymal perfusion imaging as well as vasculature imaging can be performed in real-time, using low mechanical index US technique. 4 Therefore, CEUS may aid in the detection of vascular complications following LDLT.…”