Application of contrast-enhanced ultrasound in diagnosis of hepatic artery thrombosis after liver transplantation

  Objective   To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of hepatic artery thrombosis (HAT) after liver transplantation.

  Methods   From January 2004 to August 2012, 810 patients who underwent liver transplantation in Liver Transplantation Center of West China Hospital of Sichuan University were enrolled in this study. All the recipients received Doppler ultrasound scanning after operation. CEUS examination was performed in 58 patients with suspected HAT. Based on the gold standards of hepatic artery angiography, surgical outcome and clinical follow-up, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CEUS in diagnosing HAT were calculated.

  Results   Sixteen cases were diagnosed with HAT by CEUS, in which 15 were confirmed, one was misdiagnosed and no case was missed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CEUS in diagnosing HAT were 1.0, 0.977, 0.983, 0.938 and 1.0 respectively. The incidence and mortality of HAT were 1.9%, 53% respectively in the study.

  Conclusions   When suspected with HAT by Doppler ultrasound after liver transplantation, patients should immediately receive CEUS. Patients with unobstructed hepatic artery diagnosed by CEUS can avoid receiving hepatic artery angiography.