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Diagnostic Performance for Hepatic Artery Occlusion After Liver Transplantation: Computed Tomography Angiography Versus Contrast-Enhanced Ultrasound

Title
Diagnostic Performance for Hepatic Artery Occlusion After Liver Transplantation: Computed Tomography Angiography Versus Contrast-Enhanced Ultrasound
Authors
Kim, Jin SilKim, Kyoung WonLee, JeongjinKwon, Heon-JuKwon, Jae HyunSong, Gi WonLee, Sung Gyu
Ewha Authors
김진실
SCOPUS Author ID
김진실scopus
Issue Date
2019
Journal Title
LIVER TRANSPLANTATION
ISSN
1527-6465JCR Link

1527-6473JCR Link
Citation
LIVER TRANSPLANTATION vol. 25, no. 11, pp. 1651 - 1660
Publisher
WILEY
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
The purpose of this study was to compare the diagnostic performance of computed tomography angiography (CTA) and contrast-enhanced ultrasound (CEUS) when used to diagnose significant hepatic artery occlusion (HAO) in patients that was suspected on Doppler ultrasound (US). Among 3465 adult liver transplantations (LTs) performed between January 2010 and February 2018, 329 recipients were suspected of having HAO by Doppler US. In these patients, 139 recipients who had undergone both CTA and CEUS as second-line studies were included. CTA and CEUS were retrospectively reviewed using the criteria for HAO used in previous studies (CTA, >= 50% stenosis at the anastomosis; CEUS, no HA enhancement or delayed and discontinuous enhancement). The diagnostic values of CTA and CEUS were compared using the McNemar test. CEUS showed statistically significant better accuracy and specificity than CTA in patients with Doppler US abnormality seen after LT (accuracy, 99.3% versus 89.2%, P < 0.001; specificity, 100% versus 83.1%, P < 0.001). CTA had 15 false-positive diagnoses, and CEUS had 1 false-negative diagnosis. In conclusion, CEUS showed higher specificity and positive predictive value than CTA for the diagnosis of HAO in selected patients with a Doppler US abnormality. However, even if there is no HAO diagnosed on CEUS, continuous monitoring and follow-up imaging are required when HAO is strongly suspected in the clinical setting and on CTA.
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DOI
10.1002/lt.25588
Appears in Collections:
의과대학 > 의학과 > Journal papers
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