Multislice computed tomography angiography in pediatric liver transplantation.
BACKGROUND
Preoperative delineation of any vascular anomalies offers planning for possible alteration of surgical procedures, especially in pediatric recipients undergoing living-related liver transplantation.


OBJECTIVE
We assess the efficacy of three-dimensional (3D) multislice computed tomography (CT) angiography in the hope of replacing conventional angiography as the pretransplant evaluation of the hepatic vascular system for potential recipients of liver transplantation.


METHODS
3D CT angiography was performed in 38 children with biliary atresia. Conventional angiography was also performed in the first 15 patients. Twelve patients underwent living-related liver transplantation. The findings on 3D CT angiography were compared with conventional angiography and operative findings.


RESULTS
3D CT angiography was successfully performed in 37 pediatric patients. All findings of 3D CT angiography on hepatic artery, portal vein, and inferior vena cava paralleled those of catheter angiography and operative findings. Four patients were unsuitable to receive living grafts because of pathologic insults of the hepatic artery (one patient) and the portal vein (three patients). Three patients were advised to undergo a venous graft for portal anastomoses. Eight patients demonstrated portosystemic shunts that may require closure.


CONCLUSIONS
3D CT angiography proves to be a better tool in the demonstration of the vascular system and identification of pathologic insults in pediatric patients. It is superior to conventional angiography because it is less invasive, more convenient, and more efficient in providing thorough preoperative information that would have a major impact on patient selection and surgical planning.
Cheng
Yu Fan
YF
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. f6591@ms4.hinet.net.
Chen
Chao Long
CL
Jawan
Bruno
B
Huang
Tung Liang
TL
Chen
Tai Yi
TY
Chen
Yaw Sen
YS
Wang
Chih Chi
CC
de Villa
Vanessa
V
Wang
Shih Hor
SH
Wah
Chiu King
CK
Chiang
Yuan Cheng
YC
Eng
Hock Liew
HL
Lee
Tze Yu
TY
Goto
Shigeru
S
D015901:Angiography, Digital Subtraction; D001656:Biliary Atresia / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000000981:diagnostic imaging* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging