title: 3DCT angiography for detection of vascular complications in pediatric liver transplantation.
abstract: Catheter angiography for early diagnosis of vascular complications in pediatric liver transplant yields excellent results but remains an extremely invasive examination for younger children, precluding its routine use. We assessed the efficacy of three-dimensional multislice computed tomographic angiography (3DCTA) as an alternative option in these patients.
  
  
  METHODS
  Twenty children suspected of vascular complications on clinical grounds, laboratory findings, or Doppler ultrasound underwent 3DCTA between April 2000 and April 2003. Interventional procedures via conventional angiography were subsequently performed in 5 cases, thrombolytic therapy in 4, surgical in 1, and conservative treatment in 10.
  
  
  RESULTS
  Two hepatic artery stenosis,1 hepatic artery thrombosis, 5 hepatic vein stenosis, 4 portal vein occlusion, 1 portal vein stenosis, and 7 non-vascular lesions were detected, all of which paralleled the findings of catheter angiography, Doppler ultrasound, and operations. The diagnostic accuracy for vascular complication was 90%. The sensitivity and specificity were 86.7% and 100%, respectively. The positive and negative predictive values were 100% and 71.4%, respectively. To date 19 patients are alive, with a median follow-up period of 24.8 months. In conclusion, 3DCTA is accurate and efficient in the identification of pathological vascular insults and offers essential information for major decision on further management of the vascular complications in pediatric recipients of liver transplant.
authors.affiliation: Department of Diagnostic Radiology and Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83305, Taiwan.
authors.forename: Yu Fan
authors.initials: YF
authors.lastname: Cheng
authors.forename: Chao Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Tung Liang
authors.initials: TL
authors.lastname: Huang
authors.forename: Tai Yi
authors.initials: TY
authors.lastname: Chen
authors.forename: Yaw Sen
authors.initials: YS
authors.lastname: Chen
authors.forename: Chih Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Leo Leung-chit
authors.initials: LL
authors.lastname: Tsang
authors.forename: King Wah
authors.initials: KW
authors.lastname: Chiu
authors.forename: Bruno
authors.initials: B
authors.lastname: Jawan
authors.forename: Hock Liew
authors.initials: HL
authors.lastname: Eng
mesh_terms: D000792:Angiography / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000592:standards; D007223:Infant; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*