Contrast‐enhanced ultrasound of liver lesions related to arterial thrombosis in adult liver transplantation

Fontanilla, Teresa; Noblejas, Ana; Cortés, Cristina; Minaya, Javier; Méndez, S.; Brule, Enrique Van den; Hernando, Concepción González; Alfageme, Marta; Baños, I.; Aguirre, Elisa

doi:10.1002/jcu.22069

Cited by 24 publications

(11 citation statements)

References 16 publications

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“…Hepatic artery thrombosis or stenosis can be detected using Doppler techniques. Contrast‐enhanced sonography can help improve visualization of the hepatic artery and can be used to diagnose parenchymal lesions such as liver infarction after hepatic artery thrombosis . Liver transplant patients are at increased risk for hepatic infarction when there is vascular compromise due to loss of normal collateral pathways at total hepatectomy of the native liver, especially early in the postoperative period .…”

Section: Discussionmentioning

confidence: 99%

“…Conventional sonographic appearance of infarcts has been described as rounded or geographic zones of hypoechogenicity, relative to the unaffected parenchyma . Doppler and contrast‐enhanced sonography have described infarctions as nonvascular areas and geographic parenchymal areas without enhancement during all phases, respectively . Two case series of liver infarction identified on computed tomography (CT) scans have been reported in the literature.…”

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confidence: 99%

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“Bright Band Sign” A Grayscale Ultrasound Finding in Hepatic Infarction

Whang

Chopra

Tchelepi

2019

J of Ultrasound Medicine

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Hepatic infarction is infrequent due to the dual blood supply of the liver and the compensatory relationship between the hepatic artery and portal vein. Most cases occur in liver transplants due to vascular complications. Grayscale sonography combined with color and spectral wave Doppler can assess for vessel patency and parenchymal abnormalities. Liver infarctions appear as hypoechoic nonvascular regions on conventional and Doppler sonography. Here, we describe a grayscale ultrasound feature within liver infarctions in 2 liver transplants and in 1 native liver due to iatrogenic complication. This feature is similar to those described recently in the literature within splenic infarcts.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“Bright Band Sign” A Grayscale Ultrasound Finding in Hepatic Infarction

Whang

Chopra

Tchelepi

2019

J of Ultrasound Medicine

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“…Highly important for these patients is the rapid diagnosis of stenoses, false aneurysms, thromboses, and dissections in the hepatic artery. Particularly contrast-enhanced ultrasound significantly improves visualization, while simultaneously enabling evaluation of perfusion in the liver parenchyma [3,8]. A comparison between the diagnostic accuracy of contrast-enhanced ultrasound and that of a native CT examination in patients with kidney failure revealed correct characterization of liver, kidney, and intestinal pathologies in 96%, 89%, and 100% of cases for contrast-enhanced ultrasound versus 0%, 7%, and 18% for native CT, respectively [13].…”

Section: Discussionmentioning

confidence: 99%

Bedside ultrasound after aortic surgery

et al. 2019

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Bedside ultrasound after aortic surgery Rapid detection of vascular and organ complications Vessel and organ complications occur after both open and endovascular aortic surgery. These include vascular access complications, such as bleeding and acute ischemia in cases of occlusion or dissection and also hepatic, renal and intestinal ischemia. Rapid and targeted diagnostics are essential for avoidance of long-term damage and to reduce morbidity and mortality. Bedside color duplex and contrast-enhanced ultrasound can be used in the intensive care unit for rapid diagnosis of early complications after these interventions.

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“…Bile ducts are supplied by the hepatic artery only, and the biliary epithelium is more sensitive to ischemic injury than hepatocytes [ 21 ]. Ischemia resulting from HA diseases initially affects the bile ducts, which may lead to biliary necrosis, cast formation, abscesses, non-anastomotic bile leak and bilomas [ 21 , 22 ]. In our case, the bilomas could be clearly observed by conventional ultrasound and CEUS and gradually disappeared due to blood supply to the collateral arteries.…”

Section: Discussionmentioning

confidence: 99%

Case report of hepatic artery dissection secondary to hepatic artery pseudoaneurysm after living donor liver transplantation

Chen

et al. 2016

BMC Gastroenterol

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BackgroundHepatic artery pseudoaneurysm (HAP) and Hepatic artery dissection are rare vascular complications after living donor liver transplantation (LDLT), which may lead to graft loss and death of the recipients. Conventional gray-scale and Doppler ultrasound, as well as contrast-enhanced ultrasound (CEUS), play important roles in identifying vascular complications in the early postoperative period and during follow-up. We report a case of hepatic artery dissection secondary to HAP after LDLT, which was diagnosed and followed for one year by ultrasound. To the best of our knowledge, few studies have reported similar cases after liver transplantation in the English literature.Case presentationA 43-year-old man underwent right-lobe LDLT for treatment of a severe acute hepatitis B infection and was followed up with ultrasound examinations for one year. Conventional gray-scale and Doppler ultrasound combined with contrast-enhanced ultrasound (CEUS) accurately revealed the occurrence of HA dissection secondary to HAP and accompanied by thrombosis and collateral circulation, as well as secondary biliary complications, which provided a prompt diagnosis and guidance for the treatment.ConclusionOur case suggests that ultrasound can help detect hepatic artery pseudoaneurysm and dissection, as well as secondary biliary lesions after LDLT in an accurate and timely manner and provide useful information for the treatment chosen. CEUS shows potential as an important complementary technique to gray-scale and Doppler ultrasound.

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Contrast‐enhanced ultrasound of liver lesions related to arterial thrombosis in adult liver transplantation

Abstract: CEUS was useful to diagnose lesions related to hepatic artery thrombosis in liver transplantation. It enabled distinguishing between them and to define their size and extension better than conventional gray-scale US.

Cited by 24 publications

References 16 publications

“Bright Band Sign” A Grayscale Ultrasound Finding in Hepatic Infarction

“Bright Band Sign” A Grayscale Ultrasound Finding in Hepatic Infarction

Bedside ultrasound after aortic surgery

Case report of hepatic artery dissection secondary to hepatic artery pseudoaneurysm after living donor liver transplantation

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