Hepatic Artery Occlusion after Liver Transplantation in Patients with Doppler Ultrasound Abnormality: Increasing Sensitivity of Contrast-Enhanced Ultrasound Diagnosis
- 주제(키워드) Hepatic artery occlusion , Contrast media , Ultrasonography , Diagnostic performance , Liver transplantation , Contrast-enhanced ultrasound
- 주제(기타) Radiology, Nuclear Medicine & Medical Imaging
- 설명문(일반) [Kim, Jin Sil] Ewha Womans Univ, Coll Med, Dept Radiol, Seoul, South Korea; [Kim, Jin Sil] Ewha Womans Univ, Coll Med, Med Res Inst, Seoul, South Korea; [Kim, Kyoung Won; Choi, Sang Hyun; Jeong, So Yeong] Univ Ulsan, Asan Med Ctr, Dept Radiol, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea; [Kim, Kyoung Won; Choi, Sang Hyun; Jeong, So Yeong] Univ Ulsan, Asan Med Ctr, Res Inst Radiol, Coll Med, Seoul, South Korea; [Kwon, Jae Hyun; Song, Gi Won; Lee, Sung Gyu] Univ Ulsan, Coll Med, Div Liver Transplantat & Hepatobiliary Surg, Dept Surg,Asan Med Ctr, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 hybrid, Green Published, Green Submitted
- 발행기관 KOREAN RADIOLOGICAL SOC
- 발행년도 2019
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000171899
- 본문언어 영어
- Published As https://dx.doi.org/10.3348/kjr.2018.0464
- PubMed https://pubmed.ncbi.nlm.nih.gov/30799577
초록/요약
Objective: To investigate whether diagnostic performance of contrast-enhanced ultrasound (CEUS) could be improved with modified criteria to diagnose significant hepatic artery occlusion (HAO) and to determine the role of CEUS in patients with a tardus-parvus hepatic artery (HA) pattern on Doppler US. Materials and Methods: Among 2679 adult liver transplantations performed over 7 years, HAO was suspected in 288 recipients, based on Doppler ultrasound. Among them, 130 patients underwent CEUS. After excluding two technical failures, 128 CEUS images were retrospectively reviewed to search for abnormal findings, such as no HA enhancement, abnormal HA enhancement (delayed, faint, and discontinuous enhancement), and perfusion defect in the liver parenchyma. The performance CEUS abnormalities were assessed in the patients overall and in subgroups based on Doppler ultrasound abnormality (group A, no flow; group B, tardus-parvus pattern) and were compared based on the area under the receiver operating characteristic curve (AUC). Results: HAO were diagnosed in 41 patients by surgery, angiography, or follow-up abnormality. By using the conventional criterion (no HA enhancement) to diagnose HAO in patients overall, the sensitivity, specificity, and AUC were 58.5%, 100%, and 0.793, respectively. Modified criteria for HAO (no HA enhancement, abnormal enhancement, or parenchymal perfusion defect) showed statistically significantly increased sensitivity (97.6%, 40/41) and AUC (0.959) (p < 0.001), although the specificity (95.4%, 83/87) was slightly decreased. The sensitivity and specificity of the modified criteria in Groups A and B were 97.1% (33/34) and 95.7% (22/23), and 100% (7/7) and 95.3% (61/64), respectively. Conclusion: Modified criteria could improve diagnostic performance of CEUS for HAO, particularly by increasing sensitivity. CEUS could be useful for diagnosing HAO even in patients with a tardus-parvus HA pattern on Doppler US, using modified criteria.
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