Multi-slice spiral CT diagnosis of hepatic venous outflow obstruction after liver transplantation / 中国医学影像技术

ABSTRACT

Objective To assess the value of multi-slice spiral CT in the diagnosis of hepatic venous outflow obstruction (HVO) after liver transplantation. Methods Five patients with HVO were confirmed with digital subtraction angiography and epigastric tri-phase contrast-enhanced CT scans within 4-102 days after liver transplantation, and the CT dynamic enhancement features were retrospectively evaluated. Results Among 5 patients, 2 had middle hepatic vein obstruction, 1 had left hepatic vein obstruction, 1 had right hepatic vein obstruction, and 1 had middle hepatic vein and inferior caval vein obstruction. Contrast-enhanced CT showed typical liver congestion in all 5 patients. The liver parenchyma drained by obstructed hepatic vein was low-density on CT plain scans (1 patient showed mix-density caused by liver parenchyma hemorrhage), while no enhancement on artery phase, moderate enhancement on venous phase and high enhancement on delay phase were observed. During the venous phase, peripheral portal branches were invariably enhanced in the congested area of liver parenchyma. During the delay phase, opacification of the obstructed hepatic vein could be seen. After all patients had treated with interventional therapy, their clinical symptoms were improved, and 2 patients received contrast-enhanced CT scans after interventional therapy, which showed liver congestion relieved and obstructed hepatic vein opacificated well in venous phase. Conclusion Multi-slice spiral dynamic enhancement CT scans can accurately display the location of HVO and the extent of liver congestion.