[Liver transplantation: diagnostic imaging in the preoperative assessment].
The correct selection of patients for liver transplantation, which is essential for surgical success, requires thorough radiological evaluation. The authors present their experience on 94 pretransplant adult patients that underwent a total of 251 diagnostic exams (Doppler US, CT, angiography and cholangiography) and interventional radiology maneuvers (biopsy, chemoembolization, biliary drainage). Three sclerosing cholangitis, 3 Budd-Chiari syndromes and 20 hepatocellular carcinomas in cirrhotic patients were identified; venous collaterals were present in 62.7% of the cases, 12.8%, of which had important spontaneous porto-systemic shunts; 6 patients had portal thrombosis; 20 arterial variations were found. Interventional maneuvers were useful and free of complications. US, CT and angiographic findings of each patient were compared. Integrating informations from different exams allowed a significant increase in the accuracy of diagnostic conclusions. Thanks to interventional maneuvers 5 patients could be selected for transplantation (hepatic arterial lipiodolization stopped the growth of 4 hepatic neoplasms; 2 infected fluid collections were sterilized by percutaneous US-guided drainage and topic therapy.
Veltri
A
A
Istituto di Radiologia Università, Torino.
Grosso
M
M
Regge
D
D
Capello
S
S
Kienle
S
S
Ottobrelli
A
A
Salizzoni
M
M
D000328:Adult; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care
Il trapianto del fegato: la diagnostica per immagini nel bilancio preoperatorio.