Evaluation of ultrasonography in diagnosis of biliary stricture after liver transplantation

Abstract

Objective To assess the value of ultrasonography in the diagnosis of biliary stricture after liver transplantation (LT). Methods A total of 127 patients after LT in Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University from January 2004 to March 2011 were included in this prospective study [116 males, 11 females; average age: (49±8) years old]. The informed consents of all patients were obtained and the ethical committee approval was received. Firstly, color Doppler ultrasound examination was performed in the patients. The ultrasound images were blindedly analyzed by two senior sonographers. The diagnostic indicators of biliary stricture ofter LT were hilar bile duct lumen narrowing, dilatation of bile duct, bile duct wall thickening, echo enhancement of bile duct wall. The endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) results were taken as the gold standard for diagnosing biliary stricture after LT. The diagnostic sensitivity and specificity of the 4 single indicators and combined indicators were observed. Results The diagnostic sensitivity and specificity of the 4 single indicators hilar bile duct lumen narrowing, dilatation of bile duct, bile duct wall thickening, echo enhancement of bile duct wall were 0.68 and 1.00, 1.00 and 0.73, 0.71 and 0.87, 0.80 and 0.70. The diagnostic sensitivity and specificity of combined indicators dilatation of bile duct + bile duct wall thickening or echo enhancement of bile duct wall reached 0.80 both. Conclusions Ultrasonography is useful in the diagnosis of biliary stricture after LT. Hilar bile duct lumen narrowing can be used as a direct indicator in the diagnosis of biliary stricture after LT. And the combined indicators dilatation of bile duct + bile duct wall thickening or echo enhancement of bile duct wall have higher reference value. Key words: Liver transplantation; Postoperative complications; Biliary stricture; Ultrasonography