LAVA增强血管成像探查肝移植后血管并发症的价值

The value of LAVA CE-MRA in detecting vascular complication after liver transplantation

目的评价肝脏快速容积采集(liver acquisition with volume acceleration,LAVA)动态增强诊断肝脏移植后血管并发症的能力。方法 35例肝移植后行LAVA动态增强检查,多平面重建(multiplanar reformation,MPR)肝动脉、门静脉和肝静脉系统,记录血管狭窄部位,测量并计算血管狭窄程度,并与数字减影血管造影(digital subtracted angiography,DSA)对照。增强扫描测量门静脉期和延迟期肝脏实质信号强度并与对照组比较。结果磁共振增强血管成像分别显示4例肝动脉和9例门静脉吻合口狭窄,其中12例经DSA证实,1例肝动脉狭窄高估。门静脉狭窄患者较正常人群门静脉期肝实质强化程度低(P<0.05)。结论 LAVA动态增强MPR能够良好显示肝脏移植术后血管并发症,能够无创评估肝脏实质血液灌注情况。

Objective To assess the ability of CE-MRA using a liver acquisition with volume acceleration （LAVA） sequence in detecting vascular complication after liver transplantation. Methods The CE-MRA were performed in 35 patients after liver trans- plantation. The hepatic arteries, portal veins and hepatic veins were reconstructed using MPR. The location and the extent of angiosteno- sis showed on CE-MRA were compared with DSA. The signal intensity of liver parenchyma in plain scan, portal phase and delayed phase were compared with the control group. Results The anastomotic stoma stenosis of hepatic artery and portal veins were showed on CE- MRA in 4,9 patients respectively and were consistent with DSA in 12 cases, 1 patient with hepatic artery stricture on CE-MRA was o- verestimated. The signal intensity of liver parenchyma in portal venous phase were lower than that of control group （ P 〈 0.05 ）. Conclu- sion The LAVA CE-MRA not only can delineate the vascular complication after liver transplantation, but also evaluate the condition of hepatic hemoperfusion.