title: Hepatic artery stenosis in liver transplantation: imaging and interventional treatment.
abstract: BACKGROUND
  Main purpose of our study is to demonstrate the spectral and color Doppler ultrasonography (DUS) findings that would indicate hepatic artery stenosis (HAS) after liver transplantation and to report our single center results. Moreover we want to establish role and limits of the different imaging techniques in detecting HAS, proposing a non invasive diagnostic approach and to depict indications and feasibility of endovascular treatment in the single patient.
  
  
  METHODS
  Our study consisted of 222 patients who underwent liver transplantation between January 1999 and December 2009. DUS findings were correlated with multidetector computed tomography angiography (MDCTA) and angiographic results.
  
  
  RESULTS
  HAS occurred in 21 cases (9.5%). In all cases diagnosis was performed by DUS. MDCTA quantified stenosis and showed an overall picture of splanchnic vascularization. Based on DUS and MDCTA data integration, in 9 cases we adopted the "wait and see" strategy. Moreover in 12 cases treatment was considered necessary. For hepatic artery stenosis, use of DUS criteria resulted in a sensitivity of 100% (20/20), a specificity of 99.5% (201/202), a positive predictive value (PPV) of 95% (20/21), and negative predictive value (NPV) of 100% (201/201), and an overall accuracy of 99.5% (221/222).
  
  
  CONCLUSIONS
  Our study underline the role of DUS in early diagnosis of HAS: repeated evaluation of both direct and indirect signs increases NPV and sensitivity of DUS.
authors: Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A Gemelli 8, 00168 Rome, Italy. pierluigi.rinaldi@rm.unicatt.it
authors: Pierluigi
authors: P
authors: Rinaldi
authors: Riccardo
authors: R
authors: Inchingolo
authors: Michela
authors: M
authors: Giuliani
authors: Carmine
authors: C
authors: Di Stasi
authors: Anna Maria
authors: AM
authors: De Gaetano
authors: Giulia
authors: G
authors: Maresca
authors: Lorenzo
authors: L
authors: Bonomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy; D011237:Predictive Value of Tests; D018608:Ultrasonography, Doppler