Pathologic significance of low-attenuation hepatic parenchymal abnormalities in CT scans of living related donor partial liver transplant recipients.
OBJECTIVE
To evaluate the pathologic significance of the low-attenuation changes of liver grafts in living donor partial liver transplantation (LDLT) on computed tomography (CT).


METHODS
We retrospectively correlated the low-attenuation changes of liver grafts which were defined as readings below 50 HU on unenhanced CT with histological findings obtained by needle biopsy or surgery within seven days of CT studies. The study group included 35 CT findings of 35 recipients. We classified the low-attenuation change of the liver grafts into a homogeneous low-attenuation group and a heterogeneous low-attenuation group.


RESULTS
Major histologic findings of 35 specimens included cholangitis in 10 (28.6%), cholestasis in eight (22.9%), fatty change in 15 (42.9%), acute cellular rejection (ACR) in 12 (34.3%), acute hepatitis in three (8.6%), liver cell ballooning in four (11.4%), massive hepatic necrosis in four (11.4%), and centrilobular congestion in five (14.3%) cases, respectively. Homogeneous and heterogeneous low-attenuation changes of liver grafts on unenhanced CT were seen in 26 (74.3%) and 9 (25.7%) cases, respectively. Massive hepatic necrosis occurred more frequently among the heterogeneous low-attenuation group than among the homogeneous low-attenuation group.


CONCLUSIONS
Low-attenuation changes in liver grafts on CT may indicate a variety of pathological changes. Heterogeneous low-attenuation changes suggest massive hepatic necrosis.
Ametani
Fumie
F
Department of Radiology, Kishiwada City Hospital, Osaka 596-8501, Japan.
Itoh
Kyo
K
Sakurai
Takaki
T
Shibata
Toshiya
T
Maetani
Yoji
Y
Kubo
Takeshi
T
Tanaka
Koichi
K
Konishi
Junji
J
D000293:Adolescent; D000328:Adult; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008102:Liver Circulation; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009336:Necrosis; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol