The Study Of Liver Perfusion After Transplantation With Contrast-Enhanced Ultrasonography And Preliminary Application In Ischemia-Type Biliary Lesions

Objective To investigate the hemodynamic feature of liver after transplantation and the application in diagnosing ischemia-type biliary lesions(ITBL) with real-time gray-scale quantitative contrast-enhanced ultrasonography (CEUS).Methods In the first part,30 patients after liver transplantation with normal clinical features and 35 health volunteers were engaged in this study .They were all undergone Real-time contrast enhanced ultrasonography and analyzed the perfusion and hemodynamic features by quantify software. Then a series of parameters were Achieved after analyzing the TIC,including hepatic artery arrive time(HAT),portal vein arrive time(PVAT), time to peak of portal vein(PVTTP), enhanced intense of portal vein(PEV),perfusion curve slope of portal vein(PVβ), hepatic vein arrive time(HVAT), liver parenchyma arrive tine(PAT), time to peak of liver parenchyma(PTTP), enhanced intense of liver parenchyma(PEV),perfusion curve slope of liver parenchyma(Pβ). hepatic artery-vein transit time(HAVTT), hepatic artery-portal vein transit time(HA-PVAT).after statistical analyze,the hemodynamic feature of nomal liver after transplantation were founded. In the last part,39 patients with ITBL confirmed by other examination underwent CEUS successively.ALL patients were devided into two groups according to having bile duct in liver dilatation by routing ultrasonography or not,group ITBL1 and group ITBL2.The process of CEUS were recorded by ultrasound image system and analyzed by quantification software .then a series of parameter were Achieved .these parameters were contrast with normal liver after transplantation with statistical software.the parameters of liver with ITBL different from normal liver may be summarized. AT last ,correlation study were imposed between the parameters and GGT.Results Real-time CEUS delineated clearly the dynamic enhancement of the parenchyma of liver , time—intensity curve (TIC)can display the course of agent wash-in and wash-out objectively .There is no significances (P>0.05)between the transplanted liver group and the normal liver group ,including HAAT,HVAT,HAVTT,PAT,PTTP,PEI,Pβ,PVβ,PVTTP,PVEI,PVAT .There were no significant differences in the PEI between group ITBL1 and normal liver .There were significant differences in PEI between the group ITBL1 and normal liver .There were significant differences in Pβbetween the group ITBL1,ITBL2 and the normal . There were no significant differences in other parameters between group ITBL1,ITLB2 and normal liver .There were no linear correlation between Pβand GGT in ITBL patients.Conclusions This study primary show that the hemodynamic features of transplanted liver are consistent with normal liver .It is reasonable to use the index of normal liver when diagnosing complications of liver transplant with perfusion imaging by CEUS. Camparing with normal man after transplantion,the perfusion of liver is apparently decreased in Patients with ITBL after liver transplantation.This change can be detected by CEUS sensitively .CEUS is to be a promising new technique for early diagnosis of ITBL.