Role of MDCT in the detection of early abdominal complications after orthotopic liver transplantation.
OBJECTIVE
This study aims to assess the role of multidetector computed tomography (MDCT) for detecting early abdominal complications after orthotopic liver transplantation.


METHODS
We retrospectively enrolled 170 subjects with clinical laboratory and/or echo-color Doppler abnormalities who underwent MDCT within the first 90 days after transplantation. All images were reviewed by two radiologists in conference and imaging results were correlated with digital subtraction angiography, conventional cholangiography, surgery, clinical laboratory, and/or imaging follow-up.


RESULTS
No significant complication was found in 142 patients, while vascular complications (hepatic artery thrombosis, n=5 and stenosis, n=5; portal vein thrombosis, n=4; cava vein thrombosis, n=1; arterial bleeding, n=1), biliary complications (anastomotic leak with biloma, n=6), parenchymal complications (abscess, n=1; extended areas of impaired perfusion, n=3), adrenal hemorrhage (n=1), and bowel perforation (n=1) were identified in the remaining 28 cases. Four false-positive cases (three hepatic artery stenoses and one hepatic artery dissection) and one false-negative case (biloma) were diagnosed on MDCT. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MDCT in the identification of various complications were 96%, 97%, 87%, 99%, and 97%, respectively.


CONCLUSIONS
MDCT is a reliable diagnostic technique in the identification of early abdominal complications of liver recipients.
Department of Diagnostic Radiology, Vascular and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy. Electronic address: p.boraschi@do.med.unipi.it.
Piero
P
Boraschi
Department of Diagnostic Radiology, Vascular and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Francescamaria
F
Donati
Department of Diagnostic Radiology, Vascular and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Massimiliano
M
Rossi
Hepatobiliary Surgery and Liver Transplantation Unit, Department of Oncology, Transplants and Advances in Medicine, University of Pisa Medical School Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Davide
D
Ghinolfi
Hepatobiliary Surgery and Liver Transplantation Unit, Department of Oncology, Transplants and Advances in Medicine, University of Pisa Medical School Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Franco
F
Filipponi
Department of Diagnostic Radiology, Vascular and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Fabio
F
Falaschi
D000005:Abdomen / Q000098:blood supply / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002758:Cholangiography; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011169:Portal Vein / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000000981:diagnostic imaging; D014652:Vascular Diseases / Q000000981:diagnostic imaging*; D014684:Venae Cavae / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging
Biliary; Complications; Computed tomography; Liver transplantation; Vascular