Clinical utility of hepatic-perfusion computerized tomography in living-donor liver transplantation: a preliminary study.

BACKGROUND: Vascular complications are a primary diagnostic consideration in liver transplant recipients, with an overall incidence of 9%. Cross-sectional imaging techniques provide information regarding vascular structure and luminal patency but can not quantitatively assess hepatocyte damage in the liver graft parenchyma. Perfusion computerized tomography (CT) is a recently developed method that allows for quantitative evaluation of hemodynamic changes in tissue. Our objective was to evaluate the clinical utility of perfusion CT in assessing vascular complications during living-donor liver transplantation (LDLT). METHODS: The 33 recipients were divided into 3 groups according to Doppler ultrasonographic findings: hepatic arterial complication group, portal venous complication group, and hepatic venous complication group. Blood volume (BV), blood flow (BF), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) were calculated for the affected vascular territory regions. RESULTS: Compared with normal liver parenchyma, BV, BF, ALP, and HPI were significantly lower in the hepatic arterial complication group. Although PVP and BV were significantly lower, ALP, HPI, and BF were higher in the affected vascular territory region than in normal liver parenchyma for the portal venous complication group. In the hepatic venous complication group, PVP was significantly higher and BF, ALP, and HPI significantly lower in the affected vascular territory regions than in normal liver parenchyma. CONCLUSIONS: Perfusion CT imaging is a noninvasive technique that enables the quantitative evaluation of vascular complications in the graft parenchyma after LDLT and permits a quantitative evaluation of the treatment response.

The utility of multidetector computed tomography for evaluation of congenital heart disease.

BACKGROUND: Congenital heart diseases (CHD) are the leading cause of birth defect-related deaths. Multi detector computed tomography (MDCT) plays an important role for imaging CHD in addition to echocardiography and provides a comprehensive evaluation of complex heart malformations for the referring cardiologist. The aim of the study was to evaluate the utility of MDCT in the assessment of CHD. MATERIALS AND METHODS: A 102 patients with CHD were investigated after initial assessment by echocardiography. The information obtained by MDCT and findings of echocardiography were reviewed together by paediatric cardiologists and cardiac radiologists. Perioperative anatomic descriptions, wherever available(n = 34) formed the gold standard for the comparison. RESULTS: The clinical consensus diagnosis defined 154 cardiovascular lesions in the patients. The results were classified in groups. We present the appearance of various congenital cardiac lesions seen in clinical practice. CONCLUSIONS: MDCT provides important information about anatomic details of CHD for the referring cardiologist. The evaluation of different anatomic structures such as heart, great vessels, lungs and abdomen is possible in one acquisition with this technique.

Partial anomalous pulmonary venous return associated with vascular anomalies of the aorta: multidetector computed tomography findings.

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly that involves drainage of one to three pulmonary veins directly into the right heart or systemic venous system, creating a partial left-to-right shunt. This drainage is associated with cardiac abnormalities such as mitral stenosis and pulmonary stenosis, patent ductus arteriosus, and atrial septal defects. We report a case of PAPVR associated with vascular anomalies of the aorta by multidetector computed tomography in an adult female patient.