64层螺旋CT结合后处理技术对肝移植术后并发症的评估

Value of 64-slice spiral CT with postprocessing techniques for evaluation of complications after liver transplantation

目的:探讨64层螺旋CT结合后处理技术在肝移植术后评估的应用价值。方法:选取50例(男40例、女10例)肝移植术后患者,行64层螺旋CT平扫、四期增强扫描及CTA检查,由两位放射科医师对图像进行评估,内容包括肝实质、血管、胆道情况及有无转移。将结果与彩超及临床随访行对照分析。结果:CT检查示:肝动脉并发症3例、门脉并发症6例、下腔静脉并发症4例、肝脏灌注不良17例、胆道并发症9例、肝脏复发8例、肺部转移5例,术后出现胸腔积液患者15例、肺部感染或肺不张者11例、腹腔积液者20例。彩超示:肝动脉显示不清、肝内动脉流速偏低者3例、门脉管腔内出现涡流者6例、胆道扩张者9例、右侧膈下或移植肝周积液者20例。结论:64层螺旋CT结合多种后处理技术,能准确客观反映肝实质、血管情况,早期发现术后并发症,提高手术成功率。

Objective：To discuss the values of 64-slice spiral CT with post-processing techniques in evaluation of post liver transplantation.Methods：Fifty patients（40 males,10 females） who had received liver transplantation underwent plain scan,multiphasic contrast-enhanced scan and CTA examination.Two radiologists experienced in abdominal radiology assessed the images,including liver parenchyma,vessel,biliary complication and having or no metastasis.Findings on CT imaging were compared with those on color Doppler ultrasonography and clinical follow-up.Results：Among all the patients who received 64-slice spiral CT examination,the main findings included：one case with proper hepatic artery thrombosis,one case with hepatic artery stenosis,one case with proper hepatic artery pseudoaneurysm,six cases with portal vein stenosis,four cases with inferior vena cava stenosis,seventeen cases with abnormal perfusion of liver,nine cases with biliary complications,eight cases with malignant tumors recurring,five cases with pulmonary metastasis,fifteen cases with pleural effusion,eleven cases with pulmonary infection or pulmonary atelectasis,twenty cases with seroperitoneum and four cases with portal hypertension.The main findings on color Doppler ultrasonography were：three cases with indefinite display of hepatic artery and low rate of blood flow,six cases with portal turbulent flow,nine cases with biliary dilation and twenty cases with fluid collection under right diaphrama or surrounding liver.Conclusion：64-slice spiral CT with its all kinds of reconstructions has the advantages of being quick to provide overall information of postoperative liver parenchyma,vessels and so on objectively and exactly.With these,we can detect complications of liver transplantation in time and raise the successful rate of liver transplantation.