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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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Compression of the inferior vena cava caused by fluid collection in a 7-year-old boy, 18 days after living-related liver transplantation to treat biliary atresia. Oblique coronal multiplanar reformatting images show inferior vena cava compressed (arrows) by localized fluid collections (F).
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Figure 18: Compression of the inferior vena cava caused by fluid collection in a 7-year-old boy, 18 days after living-related liver transplantation to treat biliary atresia. Oblique coronal multiplanar reformatting images show inferior vena cava compressed (arrows) by localized fluid collections (F).

Mentions: Hepatic vein and IVC complications are rare, occurring in as little as 1% to 4% of transplants (14). These complications usually result from technical problems or compression of the vessel caused by fluid collection (Fig. 18). Although hepatic venous anastomotic stenoses may occur more frequently following living-related liver transplantation than following whole liver transplantation, the incidence of these complications has been found to have decreased following the introduction of improved surgical techniques, including the triangulation technique (15). A decrease in the pulsatility of the waveform from the same hepatic vein, accompanied by an increase in the amount of ascites, on follow-up US suggests significant stenosis between the hepatic veins and IVC. Multi-slice CT can clearly delineate an anastomotic narrowing between the hepatic vein and IVC (Fig. 19), which may not be demonstrated on US, due to poor sonographic windows during the early postoperative periods, as well as liver parenchymal changes due to hepatic congestion. The multi-slice CT results must be correlated with both the US findings and the clinical signs, in order to determine their real significance.


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)

Compression of the inferior vena cava caused by fluid collection in a 7-year-old boy, 18 days after living-related liver transplantation to treat biliary atresia. Oblique coronal multiplanar reformatting images show inferior vena cava compressed (arrows) by localized fluid collections (F).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 18: Compression of the inferior vena cava caused by fluid collection in a 7-year-old boy, 18 days after living-related liver transplantation to treat biliary atresia. Oblique coronal multiplanar reformatting images show inferior vena cava compressed (arrows) by localized fluid collections (F).
Mentions: Hepatic vein and IVC complications are rare, occurring in as little as 1% to 4% of transplants (14). These complications usually result from technical problems or compression of the vessel caused by fluid collection (Fig. 18). Although hepatic venous anastomotic stenoses may occur more frequently following living-related liver transplantation than following whole liver transplantation, the incidence of these complications has been found to have decreased following the introduction of improved surgical techniques, including the triangulation technique (15). A decrease in the pulsatility of the waveform from the same hepatic vein, accompanied by an increase in the amount of ascites, on follow-up US suggests significant stenosis between the hepatic veins and IVC. Multi-slice CT can clearly delineate an anastomotic narrowing between the hepatic vein and IVC (Fig. 19), which may not be demonstrated on US, due to poor sonographic windows during the early postoperative periods, as well as liver parenchymal changes due to hepatic congestion. The multi-slice CT results must be correlated with both the US findings and the clinical signs, in order to determine their real significance.

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