Role of contrast-enhanced ultrasound in decision support for diagnosis and treatment of hepatic artery thrombosis after liver transplantation

Lu, Qiang; Zhong, Xiao; Huang, Zixing; Yu, Bo; Ma, Buyun; Ling, Wen; Wu, Hong; Yang, Jia; Luo, Yan

doi:10.1016/j.ejrad.2011.11.015

Cited by 33 publications

(24 citation statements)

References 19 publications

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“…Lack of visualization of the arterial tree, expected to be seen before portal enhancement, indicates complete arterial thrombosis with very high positive predictive values [10,32,99,131]. Identification of the arterial branches when conventional Doppler has failed [131], may allow subsequent targeted Doppler reassessment, which is needed to distinguish thrombosis from slow flow caused by vasoconstriction or splenic steal from postthrombotic/stenotic recanalization, tasks not achievable using CEUS alone.…”

Section: Image Interpretationmentioning

confidence: 99%

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012

et al. 2012

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Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some non-liver applications. Time has moved on, and the need for international guidelines on the use of CEUS in the liver has become apparent. The present document describes the third iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS) using contrast specific imaging techniques. This joint WFUMB-EFSUMB initiative has implicated experts from major leading ultrasound societies worldwide. These liver CEUS guidelines are simultaneously published in the official journals of both organizing federations (i.e., Ultrasound in Medicine and Biology for WFUMB and Ultraschall in der Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis and improve the management of patients worldwide.

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Section: Image Interpretationmentioning

confidence: 99%

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012

et al. 2012

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“…Furthermore, CEUS has been accepted as a reliable technique for the identification of certain vascular complications. Therefore, it has been suggested by several studies that for the detection of HAT, a negative CEUS would avoid unnecessary invasive angiography (16,28,41). However, this approach cannot be applied to all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant data extracted from all 13 studies are summarized in table 1 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Only two studies involved more than 100 cases for CEUS evaluation.…”

Section: Study Characteristicsmentioning

confidence: 99%

Meta-analysis of the diagnostic value of contrast-enhanced ultrasound for the detection of vascular complications after liver transplantation

Chen¹,

Xiong²,

Zhang³

et al. 2018

Rev Esp Enferm Dig

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“…CEUS has been reported to effectively improve flow visualization of the hepatic artery [4,19] and to shorten the scanning time in compared with CDUS 100% sensitivity and 97.8% accuracy for the detection of HAT [20].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound for the evaluation of hepatic artery occlusion after liver transplantation

et al. 2018

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Introduction: Vascular complications after liver transplantation remain a major threat to the survival of recipients.HAT is a major cause of graft loss and patient mortality, with an incidence between 3% to 8% in transplant recipients. Early detection of HAT is critical because urgent revascularization is required to avoid severe graft loss. Although ultrasound is the preferred first-line imaging modality in patients with suspected HAT, the accuracy and positive predictive value of HAT on Doppler US are reported to be low. Moreover, Doppler examination of the hepatic vasculature is time consuming and requires a high level of operator skill. Conventional angiography remains the gold standard for diagnosis. Recently, contrast-enhanced ultrasound (CEUS) has begun providing real-time angiographic-like images of vessels at bed side and allowing the accurate diagnosis of arterial diseases such as hepatic artery thrombosis. The purpose of this study was to evaluate the efficacy of CEUS in detecting HAT after liver transplantation: Materials and Methods: This is a retrospective data of the medical records of patients undergoing Liver transplantation in the Osmania General Hospital, Hyderabad between 2016 to 2018. Status of hepatic vascular assessment following liver transplantation done by conventional Doppler Ultra sonography and Contrast Enhanced Ultrasonography tests were obtained from registries of medical records. Results: 23 cases of post Liver transplantation aged between 4years and 58 years, with a median age of 30 years were included in the analysis. There were 20 males and 3 females. 14 patients underwent DDLT, 7 patients underwent LDLT, 1underwent split Liver transplantation and another 1 patient underwent Auto liver transplantation. Doppler US was inconclusive regarding patency of the hepatic artery (HA) circulation in 5 (21.7 %) of 23 transplantations. CEUS was performed in these 5 patients and detected HA thrombosis (HAT) in 2 cases and patent HA in 3 transplants. These 5 Transplants were confirmed by CT Angiography /conventional Angiography. In the subset of transplantations examined with CEUS, the sensitivity, specificity and accuracy of CEUS were 100%. CEUS was done at bedside without any Radiation and Nephro toxicity. In approximately 21.7% of cases, conventional Doppler US did not provide sufficient visualization of the HA after liver transplantation. In these cases, correct diagnosis was achieved by supplementary CEUS. Conclusion: CEUS may be a new approach for early diagnosis of postoperative vascular complications after Liver Transplantation, and it can be performed at the bedside. It is safe will not cause any nephron toxicity and Radiation. CEUS is a fast, non-ionizing imaging modality for the initial exclusion of vascular complications after liver transplantation. CEUS shows a high specificity and PPV in the detection of vascular complications. In unclear cases CT still is considered as the gold standard

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Role of contrast-enhanced ultrasound in decision support for diagnosis and treatment of hepatic artery thrombosis after liver transplantation

Cited by 33 publications

References 19 publications

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012

Meta-analysis of the diagnostic value of contrast-enhanced ultrasound for the detection of vascular complications after liver transplantation

Contrast-enhanced ultrasound for the evaluation of hepatic artery occlusion after liver transplantation

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