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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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Pneumobilia in a 3-year-old girl, 11 months after living-related liver transplantation to treat biliary cirrhosis. Oblique sagittal minimum intensity projection image demonstrates pneumobilia in the transplanted liver. An anastomosed site (arrow) with jejunum (J) is delineated in this patient.
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Figure 20: Pneumobilia in a 3-year-old girl, 11 months after living-related liver transplantation to treat biliary cirrhosis. Oblique sagittal minimum intensity projection image demonstrates pneumobilia in the transplanted liver. An anastomosed site (arrow) with jejunum (J) is delineated in this patient.

Mentions: Biliary complications in pediatric living-related liver transplantation are associated with increased morbidity and mortality and occur with incidences of 12% to 50% (16). These biliary complications include bile leak, bile duct stricture and dilatation, intrahepatic biloma, stone formation and pneumobilia (Fig. 20), with most occurring within 3 months of transplantation. Most biliary strictures occur at the anastomotic site and may be secondary to scar formation in the biliary tree. Although percutaneous dilatation with stenting may resolve such problems, repeat surgery is occasionall required. Nonanastomotic, intrahepatic and multiple strictures are generally caused by ischemia, due to hepatic artery stenosis or thrombosis or preservation injury. US and MR cholangiopancreatography constitute useful noninvasive methods of evaluating the biliary tree (16). Multi-slice CT, especially when combined with the MinIP technique, can also be used to demonstrate the presence of biliary complications. Mild intrahepatic bile duct dilatation is often observed in the transplanted liver and is not specific to anastomotic stenosis (17). When the CT scan reveals localized or progressive duct dilatation (Fig. 21), however, care should be taken to ensure timely diagnosis and appropriate intervention.


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)

Pneumobilia in a 3-year-old girl, 11 months after living-related liver transplantation to treat biliary cirrhosis. Oblique sagittal minimum intensity projection image demonstrates pneumobilia in the transplanted liver. An anastomosed site (arrow) with jejunum (J) is delineated in this patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 20: Pneumobilia in a 3-year-old girl, 11 months after living-related liver transplantation to treat biliary cirrhosis. Oblique sagittal minimum intensity projection image demonstrates pneumobilia in the transplanted liver. An anastomosed site (arrow) with jejunum (J) is delineated in this patient.
Mentions: Biliary complications in pediatric living-related liver transplantation are associated with increased morbidity and mortality and occur with incidences of 12% to 50% (16). These biliary complications include bile leak, bile duct stricture and dilatation, intrahepatic biloma, stone formation and pneumobilia (Fig. 20), with most occurring within 3 months of transplantation. Most biliary strictures occur at the anastomotic site and may be secondary to scar formation in the biliary tree. Although percutaneous dilatation with stenting may resolve such problems, repeat surgery is occasionall required. Nonanastomotic, intrahepatic and multiple strictures are generally caused by ischemia, due to hepatic artery stenosis or thrombosis or preservation injury. US and MR cholangiopancreatography constitute useful noninvasive methods of evaluating the biliary tree (16). Multi-slice CT, especially when combined with the MinIP technique, can also be used to demonstrate the presence of biliary complications. Mild intrahepatic bile duct dilatation is often observed in the transplanted liver and is not specific to anastomotic stenosis (17). When the CT scan reveals localized or progressive duct dilatation (Fig. 21), however, care should be taken to ensure timely diagnosis and appropriate intervention.

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