目的:超声在肝移植评估中起着核心作用。急性,亚急性,和慢性并发症可以很容易地识别使用灰度和彩色多普勒超声。超声造影为肝移植评估增加了新的维度,用精致的细节描绘血管和实质过程。此外,新出现的证据表明,超声造影可以在部分患者中定位胆漏。我们的目的是评估多参数超声的使用,包括灰度,彩色和光谱多普勒,和超声造影在肝移植中的应用。
方法:使用国家医学图书馆的MEDLINE书目数据库进行了文献综述。搜索以下术语并评估相关引文:“腹部超声,\"\"超声造影,肝脏移植,\"和\"超声波。\"
结果:灰度和彩色多普勒超声是肝移植术后评估的主要成像方式。增加对比增强起到补充作用,可以提供与同种异体移植血管相关的有价值的信息,薄壁组织,和胆道树。灰度的适当实现,彩色多普勒,超声造影可以优化灵敏度,特异性,以及检测肝移植并发症的准确性,包括肝动脉狭窄,胆漏,和感染。
结论:多模态超声评估对于确定肝移植术后并发症至关重要。超声造影在具有挑战性的病例中可能是有价值的,提供出色的解剖轮廓并降低假阳性和假阴性诊断的风险。广泛熟悉非增强和对比增强超声的适当应用可能有助于放射科医生优化同种异体移植评估并改善患者预后。
OBJECTIVE: Ultrasound plays a central role in liver transplant evaluation. Acute, subacute, and chronic complications can be readily identified using grayscale and color Doppler ultrasound. Contrast-enhanced ultrasound adds a new dimension to liver transplant evaluation, depicting vascular and parenchymal processes with exquisite detail. In addition, emerging evidence suggests that contrast-enhanced ultrasound may allow for localization of biliary leak in select patients. We aimed to assess the use of multiparametric ultrasound-including grayscale, color and spectral Doppler, and contrast-enhanced ultrasound-in the setting of liver transplantation.
METHODS: A literature review was performed using the MEDLINE bibliographic database through the National Library of Medicine. The following terms were searched and relevant citations assessed: \"abdominal ultrasound,\" \"contrast-enhanced ultrasound,\" \"liver transplant,\" and \"ultrasound.\"
RESULTS: Grayscale and color Doppler ultrasound represent the mainstay imaging modalities for postoperative liver transplant evaluation. The addition of contrast enhancement plays a complementary role and can provide valuable information related to the allograft vasculature, parenchyma, and biliary tree. The appropriate implementation of grayscale, color Doppler, and contrast-enhanced ultrasound can optimize sensitivity, specificity, and accuracy for the detection of liver transplantation complications, including hepatic artery stenosis, biliary leakage, and infection.
CONCLUSIONS: Multimodal sonographic evaluation is essential to identify postoperative complications in liver transplant recipients. Contrast-enhanced ultrasound may be of value in challenging cases, providing excellent anatomic delineation and reducing the risk of false-positive and false-negative diagnoses. A broad familiarity with appropriate applications of both nonenhanced and contrast-enhanced ultrasound may help radiologists optimize allograft assessment and improve patient outcomes.