AIM: To investigate the diagnostic performance of multi-detector computed tomography(MDCT) in detecting biliary complications after orthotopic liver transplantation(OLT). METHODS: Eighty-three consecutive OLT recipien...AIM: To investigate the diagnostic performance of multi-detector computed tomography(MDCT) in detecting biliary complications after orthotopic liver transplantation(OLT). METHODS: Eighty-three consecutive OLT recipients, who presented with clinical or biochemical signs of biliary complications, underwent MDCT examination. Two experienced radiologists assessed MDCT images in consensus to determine biliary complications. Final confirmation was based on percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography in 58 patients, surgery in four patients, liver biopsy in 10, and clinical and sonography follow-up in 11 patients. RESULTS: Biliary complications were eventually confirmed in 62 of 83 patients(74.7%), including anastomotic biliary strictures in 32, nonanastomotic biliarystrictures in 21, biliary stones in nine(5 with biliary strictures), anastomotic bile leak in five, and biloma in six(all with nonanastomotic strictures, and 2 with biligenic hepatic abscess). Twenty-one patients had no detection of biliary complications. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT for detecting biliary strictures were 90.6%, 86.7%, 89.2%, 92.3% and 83.9%, respectively. For detecting biliary stones, anastomotic bile leak and biloma, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT were all 100%.CONCLUSION: MDCT is a useful screening tool for detecting biliary complications after OLT.展开更多
基金Supported by National Natural Science Foundation of China,No.81201090,No.81371655Guangdong Natural Science Foundation,No.S2012010008367
文摘AIM: To investigate the diagnostic performance of multi-detector computed tomography(MDCT) in detecting biliary complications after orthotopic liver transplantation(OLT). METHODS: Eighty-three consecutive OLT recipients, who presented with clinical or biochemical signs of biliary complications, underwent MDCT examination. Two experienced radiologists assessed MDCT images in consensus to determine biliary complications. Final confirmation was based on percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography in 58 patients, surgery in four patients, liver biopsy in 10, and clinical and sonography follow-up in 11 patients. RESULTS: Biliary complications were eventually confirmed in 62 of 83 patients(74.7%), including anastomotic biliary strictures in 32, nonanastomotic biliarystrictures in 21, biliary stones in nine(5 with biliary strictures), anastomotic bile leak in five, and biloma in six(all with nonanastomotic strictures, and 2 with biligenic hepatic abscess). Twenty-one patients had no detection of biliary complications. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT for detecting biliary strictures were 90.6%, 86.7%, 89.2%, 92.3% and 83.9%, respectively. For detecting biliary stones, anastomotic bile leak and biloma, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT were all 100%.CONCLUSION: MDCT is a useful screening tool for detecting biliary complications after OLT.