Evaluation of the microcirculatory disturbance of biliary ischemia after liver transplantation with contrast-enhanced ultrasound: preliminary experience.
The aim of this study was to determine the efficacy of contrast-enhanced ultrasound for depicting the perfusion of hilar bile ducts in ischemic-type biliary lesions after orthotopic liver transplantation. Thirteen transplant recipients with ischemic-type biliary lesions and 12 patients without ischemic-type biliary lesions underwent ultrasound examinations after the injection of 1.5 mL of an intravenous contrast agent. The enhancement of the hilar bile duct wall in the arterial, portal venous, and late phases was qualitatively graded as higher, equal, lower, or none with respect to that of the adjacent liver parenchyma. No or low contrast enhancement was seen in 10 of 13 patients (76.90%) with biliary ischemia, whereas increased contrast enhancement with respect to the normal liver parenchyma was found in all 12 patients without biliary ischemia. The difference in the enhancement patterns between the 2 groups was significant (P = 0.0001). In conclusion, contrast-enhanced ultrasound is a new imaging modality to depict perfusion of the hilar bile duct. No or low contrast enhancement of the bile duct wall in the arterial phase may reflect the microcirculatory disturbance of biliary ischemia and may contribute to its early diagnosis.
Ren
Jie
J
Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Lu
Ming-De
MD
Zheng
Rong-Qin
RQ
Lu
Min-Qiang
MQ
Liao
Mei
M
Mao
Yong-Jiang
YJ
Zheng
Zhi-Juan
ZJ
Lu
Yan
Y
D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000098:blood supply*; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D045423:Microbubbles; D008833:Microcirculation; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media