Imaging in Hepatic Transplantation

Pl, Davis; Dh, Van Thiel; Zajko, AB; Wl, Campbell; Jh, Sumkin; Ma, Rothschild

doi:10.1055/s-2008-1040500

Cited by 8 publications

(4 citation statements)

References 1 publication

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“…Patency of the portal venous system is a major concern in candidates for hepatic transplantation (1). Today, portal venous thrombosis is not regarded as a contraindication for this procedure, but the extent of thrombosis is important for surgical planning (19).…”

Section: Discussionmentioning

confidence: 99%

“…IMAGING OF THE POFSAL VENOUS SYSTEM plays an increasingly important role in a number of clinical scenarios. Special attention has been given to the pretransplant evaluation of patients with end-stage hepatic dysfunction (1). Currently, digital subtraction x-ray angiogrdphy is the most commonly used imaging method lo determine portal venous anatomy and patency (1).…”

mentioning

confidence: 99%

“…Special attention has been given to the pretransplant evaluation of patients with end-stage hepatic dysfunction (1). Currently, digital subtraction x-ray angiogrdphy is the most commonly used imaging method lo determine portal venous anatomy and patency (1). Recently, magnetic resonance angiography of the portal venous system has been demonstrated to yield both highly sensitive and specific diagnoses of portal vein patency (2).…”

mentioning

confidence: 99%

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Evaluation of portal MR angiography using superparamagnetic iron oxide

Knollmann

Böck

Teltenkötter

et al. 1997

Magnetic Resonance Imaging

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The purpose of our research was to determine the effects of superparamagnetic iron oxide on MR imaging of the portal venous system. Eight piglets were examined in deep anaesthesia and respiratory arrest using a time-of-flight magnetic resonance fast low angle shot, two-dimensional angiography sequence at 1.5T, MR angiograms were acquired precontrast and after intravenous administration of a cumulative dose of 10, 20 and 40 mumol/kg SHU 555A, a superparamagnetic iron oxide contrast agent for MR imaging with a particle size of 60 nm. For each dose, two subsequent sets of scans were obtained and reconstructed by a maximum-intensity-projection algorithm. Hepatic parenchymal and portal venous signal intensities were measured, and portal vein contrast calculated for each set of scans. All examinations were visually rated as to portal vein contrast and homogeneity by two blinded observers. Receiver operating characteristics of both observers were analyzed. The contrast agent reduced hepatic parenchymal signal in a dose-dependent way. After a cumulative dose of 10 mumol iron oxide, hepatic parenchymal signal intensity decreased to 63 +/- 6% (average of measurements at 4 and 14 minutes, mean +/- standard error of the mean), after 20 mumol to 24 +/- 3%, and after 40 mumol to 12 +/- 1% of control. Intravascular signal in the left main portal vein branch increased to 117 +/- 6%, 127 +/- 10%, and 133 +/- 9% of control, respectively. The contrast-to-noise ratio of the portal vein improved (521 +/- 90%, 891 +/- 178%, and 995 +/- 201% of control in the left portal vein main branch). Intravascular signal intensities increased slightly. The combined effect improved contrast of the portal vein stem and its branches. Receiver operating characteristics analysis documented dose-dependency of contrast medium effects on portal venous contrast and intravascular homogeneity. Visual rating also indicated a positive effect on portal venous contrast. The superparamagnetic iron oxide agent improved portal venous contrast with surrounding hepatic parenchyma in this normal animal model, and could potentially result in more accurate diagnosis of portal venous pathology.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Evaluation of portal MR angiography using superparamagnetic iron oxide

Knollmann

Böck

Teltenkötter

et al. 1997

Magnetic Resonance Imaging

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“…Biochemical parameters have been shown to be of limited clinical value in the immediate postoperative period (Esquivel et al 1985). Although radionuclide imaging (Brown et al 1986;Hawkins et al 1988;Loken et al 1986), ultrasonography (Dalen et al 1988;Davis et al 1989;Letourneau et al 1987a), computed tomography (Dalen et al 1988;Letourneau et al 1987b), angiography (White et al 1987) and cholangiography (Bauman et al 1989;Zajko et al 1985) have been used in the evaluation of posttransplant complications, liver biopsy remains the gold standard. Loken et al (1986), Brown et al (1986) and Hawkins et al (1988) have shown the value of DISIDA scintigraphy in liver transplant patients with biliary and vascular complications, infections and rejection.…”

Section: Discussionmentioning

confidence: 99%

Liver transplant rejection and cholestasis: comparison of technetium 99m-diisopropyl iminodiacetic acid hepatobiliary imaging with liver biopsy

et al. 1992

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To determine whether the scintigraphic evaluation of technetium-99m diisopropyl iminodiacetic acid (DISIDA) uptake and excretion can distinguish among liver transplant patients with biopsy evidence for rejection, cholestasis or neither condition, we reviewed scintigrams and biopsies in 36 patients. There were 76 scintigrams with corresponding biopsies. Uptake and excretion were graded from image data on scales reflecting normal through severely abnormal values. Biopsies were evaluated for findings of cholestasis and rejection. The majority of scintigrams demonstrated normal uptake (60/75, 80%) and delayed excretion (65/76, 85%), which was most marked immediately after transplantation. One-way analysis of variance showed that the mean excretion values significantly differed between patients with normal biopsies and those with cholestasis and/or rejection (P = 0.0003). However, mean uptake scores demonstrated no statistically significant difference between these two groups of patients (P = 0.1). These findings suggest that 99mTc-DISIDA scintigraphy can differentiate between transplants with and without rejection/cholestasis but not between rejection and cholestasis. If 99mTc-DISIDA excretion is normal, rejection and cholestasis are unlikely.

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Hepatic Transplantation and Portal Hypertension

Thiel

1991

Portal Hypertension

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Imaging in Hepatic Transplantation

Cited by 8 publications

References 1 publication

Evaluation of portal MR angiography using superparamagnetic iron oxide

Evaluation of portal MR angiography using superparamagnetic iron oxide

Liver transplant rejection and cholestasis: comparison of technetium 99m-diisopropyl iminodiacetic acid hepatobiliary imaging with liver biopsy

Hepatic Transplantation and Portal Hypertension

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