MRI诊断56例肝移植术后移植肝实质并发症

MRI diagnosis of liver grafts complications after liver transplantation

目的探讨MRI对肝移植术后移植肝实质并发症的诊断价值。方法 56例肝移植术后患者均接受MR常规序列扫描(Fiesta、Dual-Echo、FSPGR、FS FSE RT、DWI)及LAVA薄层动态增强检查,分析各序列影像表现。结果肝实质动脉期异常灌注15例;肝内肿瘤复发9例,伴下腔静脉、门静脉及肝静脉癌栓3例;肝局灶性缺血、坏死2例,胆源性肝脓肿2例,肝脏周围炎2例,灶性肝出血2例,局灶性脂肪肝2例,弥漫性脂肪肝1例,肝淤血1例,肝嗜酸性肉芽肿1例,未分化肉瘤1例。结论 MRI可准确反映移植肝实质各种并发症,在其临床诊断及治疗方案的制定中具有重要价值。

Objective To observe the value of MRI in the diagnosis of liver grafts complications after orthotopic liver transplantation.Methods A total of 56 patients after orthotopic liver transplantation underwent MR examination using Fiesta,Dual-Echo,FSPGR,FS FSE RT and DWI.The dynamic contrast-enhanced liver acquisition with volume acceleration（LAVA） was performed,and imaging findings after liver transplantation were analyzed.Results MRI revealed hepatic hyperperfusion in arterial phase（n=15）,liver tumor recurrence（n=9） with the tumor thrombus in the inferior vena cava and portal vein in 3 cases.There were localized liver ischemia and necrosis（n=2）,biliary abscess（n=2）,inflammation around the liver（n=2）,focal hematoma foci（n=2）,localized（n=2） and diffuse fatty infiltration of the liver（n=1）,hepatic congestion（n=1） after living-donor liver transplantation.In addition,liver eosinophilic granuloma（n=1） and undifferentiated embryonal sarcoma of the liver（n=1） were found.Conclusion MRI can accurately demonstrate all kinds of liver grafts complications after orthotopic liver transplantation,which is of important value in the guidance of clinical diagnosis and formulating treatment plan.