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Multi-slice spiral CT of living-related liver transplantation in children: pictorial essay.

Choi SH, Goo HW, Yoon CH - Korean J Radiol (2004 Jul-Sep)

Bottom Line: Multiplanar and three-dimensional imaging using multi-slice spiral CT can be used for preoperative vascular imaging, as well as for evaluating postoperative complications.In this essay, we describe the usefulness of multi-slice CT, combined with a variety of different reconstruction techniques, for the preoperative evaluation of transplant recipients.In addition, we demonstrate the multi-slice CT findings of postoperative complications, including vascular stenosis or thrombosis, bile duct leak or stricture, and extrahepatic fluid collection.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.

ABSTRACT
In pediatric living-related liver transplantation, preoperative evaluation of the recipient is important for surgical planning, while the accurate diagnosis of postoperative complications is essential for graft salvage. Multiplanar and three-dimensional imaging using multi-slice spiral CT can be used for preoperative vascular imaging, as well as for evaluating postoperative complications. In this essay, we describe the usefulness of multi-slice CT, combined with a variety of different reconstruction techniques, for the preoperative evaluation of transplant recipients. In addition, we demonstrate the multi-slice CT findings of postoperative complications, including vascular stenosis or thrombosis, bile duct leak or stricture, and extrahepatic fluid collection.

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Related in: MedlinePlus

Portal vein stenosis in an 1-year-old girl. Oblique axial maximum intensity projection image shows a small main portal vein (long arrow). Both the right and left portal veins have very small diameters (arrows). Prominent hepatic arteries (*) are noted at the hepatic hilum.
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Figure 5: Portal vein stenosis in an 1-year-old girl. Oblique axial maximum intensity projection image shows a small main portal vein (long arrow). Both the right and left portal veins have very small diameters (arrows). Prominent hepatic arteries (*) are noted at the hepatic hilum.

Mentions: The patency and diameter of the extrahepatic portal vein are the most important parameters obtained from the preoperative evaluation (6). Infants and young children with end-stage liver disease, particularly those with biliary atresia, may have diminutive portal veins (Fig. 5), which may necessitate operative dissection back to the confluence of the splenic and superior mesenteric veins for the purpose of anastomosis with the donor portal vein or the interposition of a portal venous graft. If the diameter of the main portal vein is less than 4 mm, the vein should be traced back to its origin and measured at the confluence of the splenic and superior mesenteric veins (6). Portal vein thrombosis is a common complication of liver cirrhosis. It may complicate surgical procedures during transplantation, especially when the proximal portion of the portal vein is involved. The extents of portal vein thrombosis and periportal collateral formation are accurately delineated on 3D reconstructed images (Fig. 6).


Multi-slice spiral CT of living-related liver transplantation in children: pictorial essay.

Choi SH, Goo HW, Yoon CH - Korean J Radiol (2004 Jul-Sep)

Portal vein stenosis in an 1-year-old girl. Oblique axial maximum intensity projection image shows a small main portal vein (long arrow). Both the right and left portal veins have very small diameters (arrows). Prominent hepatic arteries (*) are noted at the hepatic hilum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698162&req=5

Figure 5: Portal vein stenosis in an 1-year-old girl. Oblique axial maximum intensity projection image shows a small main portal vein (long arrow). Both the right and left portal veins have very small diameters (arrows). Prominent hepatic arteries (*) are noted at the hepatic hilum.
Mentions: The patency and diameter of the extrahepatic portal vein are the most important parameters obtained from the preoperative evaluation (6). Infants and young children with end-stage liver disease, particularly those with biliary atresia, may have diminutive portal veins (Fig. 5), which may necessitate operative dissection back to the confluence of the splenic and superior mesenteric veins for the purpose of anastomosis with the donor portal vein or the interposition of a portal venous graft. If the diameter of the main portal vein is less than 4 mm, the vein should be traced back to its origin and measured at the confluence of the splenic and superior mesenteric veins (6). Portal vein thrombosis is a common complication of liver cirrhosis. It may complicate surgical procedures during transplantation, especially when the proximal portion of the portal vein is involved. The extents of portal vein thrombosis and periportal collateral formation are accurately delineated on 3D reconstructed images (Fig. 6).

Bottom Line: Multiplanar and three-dimensional imaging using multi-slice spiral CT can be used for preoperative vascular imaging, as well as for evaluating postoperative complications.In this essay, we describe the usefulness of multi-slice CT, combined with a variety of different reconstruction techniques, for the preoperative evaluation of transplant recipients.In addition, we demonstrate the multi-slice CT findings of postoperative complications, including vascular stenosis or thrombosis, bile duct leak or stricture, and extrahepatic fluid collection.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.

ABSTRACT
In pediatric living-related liver transplantation, preoperative evaluation of the recipient is important for surgical planning, while the accurate diagnosis of postoperative complications is essential for graft salvage. Multiplanar and three-dimensional imaging using multi-slice spiral CT can be used for preoperative vascular imaging, as well as for evaluating postoperative complications. In this essay, we describe the usefulness of multi-slice CT, combined with a variety of different reconstruction techniques, for the preoperative evaluation of transplant recipients. In addition, we demonstrate the multi-slice CT findings of postoperative complications, including vascular stenosis or thrombosis, bile duct leak or stricture, and extrahepatic fluid collection.

Show MeSH
Related in: MedlinePlus