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Hepatic Artery Occlusion after Liver Transplantation in Patients with Doppler Ultrasound Abnormality: Increasing Sensitivity of Contrast-Enhanced Ultrasound Diagnosis

Title
Hepatic Artery Occlusion after Liver Transplantation in Patients with Doppler Ultrasound Abnormality: Increasing Sensitivity of Contrast-Enhanced Ultrasound Diagnosis
Authors
Kim, Jin SilKim, Kyoung WonChoi, Sang HyunJeong, So YeongKwon, Jae HyunSong, Gi WonLee, Sung Gyu
Ewha Authors
김진실
SCOPUS Author ID
김진실scopus
Issue Date
2019
Journal Title
KOREAN JOURNAL OF RADIOLOGY
ISSN
1229-6929JCR Link

2005-8330JCR Link
Citation
KOREAN JOURNAL OF RADIOLOGY vol. 20, no. 3
Keywords
Hepatic artery occlusionContrast mediaUltrasonographyDiagnostic performanceLiver transplantationContrast-enhanced ultrasound
Publisher
KOREAN RADIOLOGICAL SOC
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
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.
DOI
10.3348/kjr.2018.0464
Appears in Collections:
의과대학 > 의학과 > Journal papers
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