肝移植术后并发症的影像学诊断

目的系统分析肝移植术后正常及常见并发症的影像学表现。方法使用Philips Secura螺旋CT扫描仪对50例肝移植术后患者进行检查,CT扫描范围自膈顶至腰3椎体下缘水平,对比剂1.3mL/kg体质量,注药流率2.5mL/s,延迟时间30、60、120s。对拔除T管后出现胆管并发症患者使用Philips Gyroscan NT1.5T磁共振扫描仪检查。使用GE Advance Lp/Lc数字血管造影机,经股动脉穿刺进行肝动脉造影。结果27例肝移植术后患者出现移植肝下积液及右侧胸腔积液,门静脉伴行影像4例,肝动脉吻合口狭窄2例,肝动脉血栓1例,门静脉吻合口狭窄2例,胆管吻合口部位狭窄1例,非吻合口狭窄3例,胆瘘4例,肿瘤复发4例。结论CT、磁共振胆道水成像(MRCP)和数字减影(DSA)可以清晰显示肝移植术后血管、胆管并发症及其他少见并发症。

The imaging diagnosis of complications after liver transplantation

Objective To comprehensively analyze the imaging manifestations of normal transplanted livers and the transplantation-related complications. Methods With Philips Secura spiral CT scanner, 50 patients who underment liver transplantation received CT exam. The scanning range was from the diaphragmatic fornix to the inferior border of L3. For enhanced CT scanning, dosage of 1.3mL/kg contrast agent was used with injection rate of 2.5mL/s and delayed time of 30s, 60s, 120s, respectively. With Philips Gyroscan NT Release 7 MR, MRI scan was performed in the patients who developed biliary complications after extraction of “T” tube. With GE Advance Lp/Lc DSA,angiography of hepatic artery was performed through femoral artery. Results 27 patients showed perihepatic effusion, right pleural effusion. The other findings included accompanying shadow of portal vein((n=4)), anastomotic stenosis of hepatic artery (n=2), thrombus of hepatic artery (n=1), portal vein anastomotic stenosis (n=2), biliary anastomotic stenosis (n=1), bile duct stenosis (n=3), bile fistula (n=4), and tumor recurrence (n=4). Conclusion Multi-slice spiral CT and MRCP can clearly show the vascular and biliary complications and other complications such as tumor recurrence in patients having received liver transplantation.