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AbstractAbstract
[en] Objective: To evaluate multislice CT in the diagnosis of biliary complications after liver transplantation. Methods: Eighty-three consecutive patients who had undergone orthotopic liver transplantation (OLT) presented with clinical or biochemical signs of biliary complications and underwent contrast-enhancement CT examination. Three experienced radiologists, who were blinded to patient's clinical data, assessed CT images for the detection of biliary complications in consensus. Diagnostic confirmation of biliary complications was obtained with direct cholangiography in 69 patients, histologic study in 11 patients and hepaticojejunostomy in 3 patients. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for the detection of biliary complications were calculated. In addition, CT features of anastomotic biliary stricture (ABS) were compared with those of non-anastomotic biliary stricture (NABS) using χ2 test. Results: A total of 62 biliary complications (74.7%) was eventually confirmed in the 83 patients, including ABS in 32 patients, NABS in 21 patients, biliary duct stones in 16 patients (of which 12 patients with biliary stricture) , anastomotic bile leakage in 5 patients, biloma in 4 patients with biliary stricture, and biliogenic abscess in 2 patients with biliary stricture. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for the detection of biliary stricture were 90.6%, 86.7%, 89.2%, 92.3% and 83.9%, respectively. Other biliary complications, including biliary duct stones (16 cases), anastomotic bile leak (5 cases), biloma (4 cases), and biliogenic abscess (2 cases), were correctly diagnosed by CT; there was no false-positive or false-negative result. The incidence of irregular dilatation of bile duct was 71.4% (15/21), which was significantly higher in NABS cases than in ABS of 25.0% (8/32, P<0.01); whereas the incidence of extrahepatic biliary dilatation was 33.3% (7/21) and regular dilatation was 14.3% (3/21), which was significantly lower in NABS cases than in ABS of 84.4% (27/32) and 68.8% (22/32), respectively (P<0.01). Of 21 patients with NABS, 66.7% (14/21) complicated with hepatic artery stenosis or thrombosis, which was markedly more than that of NABS cases (15.6%, 5/32,P<0.01). Conclusions: Multislice CT is a useful imaging procedure in the detection of biliary complications after liver transplantation, and biliary stricture can be primitively classified into ABS and NABS by CT. Hepatic artery ischemia is an important factor that causes NABS. (authors)
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9 figs., 1 tab., 14 refs.
Record Type
Journal Article
Journal
Chinese Journal of Radiology; ISSN 1005-1201;
; v. 43(5); p. 504-508

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ANEMIAS, BIOLOGICAL MATERIALS, BLOOD VESSELS, BODY, BODY FLUIDS, CARDIOVASCULAR DISEASES, CARDIOVASCULAR SYSTEM, COMPUTERIZED TOMOGRAPHY, CONFIGURATION, DIAGNOSTIC TECHNIQUES, DIGESTIVE SYSTEM, DISEASES, GLANDS, HEMIC DISEASES, MATERIALS, ORGANS, PATHOLOGICAL CHANGES, SYMPTOMS, TOMOGRAPHY, VASCULAR DISEASES
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