肝移植术后并发症的影像学评价

Imaging Evaluation of Complications of Liver Transplantation

目的:采用多种影像学措施评价肝脏移植术后并发症。材料和方法:16例背驮式原位肝移植术患者,术后7天内每日行胸片及胸腹部超声检查。术后2周～12个月,当患者出现发烧、皮肤巩膜黄染及异常B型超声发现时,行上腹部CT检查5例8次、同时行胸部CT检查2例、上腹部MRI及MRCP检查6例、ERCP检查4例、PTC检查2例、“T”管造影2例和下腔静脉造影1例。结果:术后1周内诊断胸腔积液14例(14/16);术后1～2周诊断肺部感染7例(7/16);肺不张4例(4/16)。术后4个月和8个月诊断右肺和移植肝多发转移瘤各1例(2/6);术后3周～10个月诊断胆总管吻合口狭窄、胆管炎、胆泥形成等5例(5/16)。术后2周诊断下腔静脉狭窄1例(2/16)。结论:运用多种影像学检查方法有助于及时诊断肝移植术后并发症。

Purpose： To evaluate the postoperative complications of liver transplantation using multiple imaging modalities. Materials and Methods： On 16 cases of piggyback liver transplantation, a daily chest film, abdomen and thoracic cavity ultrasound screening were performed in the early 7 days after surgery. Between 2 weeks to 12 months, 8 abdominal CT scans on 5 patients, chest CT on 2 patients, MRI and MRCP on 6 patitients, ERCP on 4 patients, PTC on 2 patients, ＂T＂ tube on 2 patients and IVC venography on 1 patients were performed when fever, xanthochromia or icteric scleraepigastric occurred. Results： During the first week, pleural effusion was detected on 14 patients （14/16）. 7 case of pulmonary infection （7/16） and 4 cases of pulmonary atelectasis（4/16） were detected in the first 2 weeks. Of the 6 hepatic cellular carcinoma patients, metastasis to the right lung and the transplanted liver was detected on 2 cases （2/6）. Between 3rd week and 10th month, biliary stenosis, cholangitis, sludge were detected on 5 patients （5/16）. 1 case of IVC stenosis was detected at the 2nd week （1/16 ）. Conclusion： Multiple modalities examinations were helpful for the detection of complication of piggyback liver transplantation.