The Preliminary Study Of Multi-slice Spiral CT In The Diagnosis Of Complications After Liver Transplantation

Objective：Liver transplant has become the treatment of end-stage liver disease, congenitaland metabolic diseases such as liver disease and liver tumors effective means[1], but avariety of complications after transplantation seriously restricts the prognosis of livertransplantation. In recent years, the application of imaging examination on graftrepair work has important clinical significance. This study explores graftpostoperative complications imaging findings and the ability of multislice CT in thediagnosis of various complications; To evaluate multislice CT examination in theetiology of liver transplantation ischemic injury value; Analysis of the occurrence oftransplanted liver ischemic injury and the intrinsic relationship between vascularlesion.Methods：59cases were retrospectively analyzed between January2012and February2012patients undergoing orthotopic liver transplantation in our hospital, amongthem,53cases of postoperative patients examined by MSCT, preliminary studies:1、In14cases of abnormal ultrasonic tip blood vessels or clinical symptomaticpatients as the research object, by DSA examination results as the gold standard, theevaluation of MSCT and CTA imaging in the diagnosis of vascular lesions and theaccuracy of the diagnosis ability.2、In27patients with clinically suspected biliary complications as the researchobject, analyses the accuracy of CT in the diagnosis of bile duct stricture; At thesame time in20patients with biliary tract disease, which was confirmed by ERCP were as the research object, analysis of CT manifestations of ischemic biliary injury.3、 To explore the occurrence of liver parenchyma ischemic injury and theintrinsic relationship between vascular lesion.4、 Other complications: tumor recurrence, thoracic and abdominal cavityeffusion.Results：1、Compared with DSAexamination results, analysis of CTAin the diagnosis ofhepatic artery, portal vein stenosis and thrombosis of the degree of accuracy,sensitivity, specific, negative predictive value and positive predictive value of100%.2、This group of20cases of biliary lesions confirmed by ERCP: including16cases of bile duct of liver inside and outside the narrow (9cases, non ischemicischemic stenosis is7cases), including concurrent gallstone liver abscess in1case,bile duct stones in2cases,1cases of receptors for different width，biliary fistula (3cases). Biliary fistula multilayer CT manifestations of hepatic mun, gallbladder areaand abdominal cavity effusion, fistula location is often not clear. Multilayer CT inthe diagnosis of2cases of liver abscess, one case of confirmed; Another example ofpathology confirmed merger, graft versus host disease.16cases of biliary tract stenosis patients have different degrees of intrahepaticbile ducts dilation; CT in the diagnosis of false negative in2cases, false positives (3cases); The accuracy of CT in the diagnosis of biliary stricture81.48%(22/27)sensitivity, speciality rate72.73%(8/11) and87.50%(14/16), negative predictivevalue80.00%(8/10) and positive predictive value82.35%(14/17); Layers of CT inthe diagnosis of biliary stricture with intrahepatic bile duct uneven expansion but noexpansion for the diagnosis of bile duct of liver mun, CT diagnosis of false positivein2cases, false negative in1case; Diagnosis of ischemic biliary stricture sensitivityaccuracy of81.25%(13/16),88.89%(8/9), specific degree is71.42%(5/7), negativepredictive value83.33%(5/6) and positive predictive value80.00%(8/10).3、Other 5cases died of primary hepatic failure after transplantation,1case withmultiple organ failure after transplantation, and intraperitoneal bleeding and death.Pleural effusion was recorded in16cases, of which7cases, bilateral pleural effusionin the right side of the larger2cases; On the right side pleural effusion8cases; Onthe left side of the pleural effusion in1case.Conclusion：Multislice CT scan can clearly show the postoperative imaging findings of livertransplantation, and has the ability of diagnosis of liver transplantation postoperativecomplications. At the same time can be intuitive and accurately show the region andthe degree of the hepatic artery, portal vein vascular lesions and scope, andtransplanted liver ischemia zone. Hepatic artery abnormalities associated with biliarycomplications, abnormal hepatic artery can directly lead to biliary stricture andobstruction.