Hepatic venous congestion after right-lobe living-donor liver transplantation: the added value of delayed-phase imaging on CT.
OBJECTIVE
To describe and determine the additional value of delayed-phase imaging of hepatic venous congestion after living-donor liver transplantation.


METHODS
Twenty-eight patients who had surgical ligation of the middle hepatic vein (HV) in living-donor liver transplantation underwent 3-phase computed tomography scans. Two radiologists analyzed in consensus the presence and pattern of the hepatic attenuation difference and the opacification of the HV in the congested areas of the liver during each phase of the initial and follow-up computed tomography scanning. The imaging findings were correlated with the serum bilirubin level.


RESULTS
Opacification of the HV was observed more frequently in 22 (92%) of 24 hyperattenuating areas on delayed-phase (DP) scans than in 2 (50%) of 4 hypoattenuating areas in the congested areas of the liver. Patients with persistent hypoattenuatation in the congested areas on all phases (14%) showed significantly persistent hyperbilirubinemia after postoperative 4 weeks and showed a higher mortality rate (50%) than did the other patients with hyperattenuation on DP scans.


CONCLUSIONS
A hypoattenuating area of the liver during DP scans indicates severe hepatic congestion and is correlated with hyperbilirubinemia and a high mortality rate.
Park
Eun-Ah
EA
Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Chongno-Gu, Seoul, Korea.
Lee
Jeong Min
JM
Kim
Se Hyung
SH
Lee
Min Woo
MW
Han
Joon Koo
JK
Choi
Byung Ihn
BI
Lee
Jae Young
JY
Lee
Whal
W
Chung
Jin Wook
JW
Park
Jae Hyung
JH
D000328:Adult; D001663:Bilirubin / Q000097:blood; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007472:Iohexol / Q000031:analogs & derivatives; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008102:Liver Circulation; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D001663:Bilirubin