Quantitative analysis of contrast-enhanced ultrasonography following living donor liver transplantation: early diagnosis of middle hepatic venous occlusion.

Abstract

This study aimed to evaluate whether a quantitative contrast-enhanced ultrasonography (CEUS) study is feasibleto diagnose middle hepatic venous occlusion after living donor liver transplantation (LDLT). FromDecember 2018 to July 2019, the CEUS study on the first postoperative day had been conducted in patients who underwentLDLT. 46 patients were finally included in the study. To obtain CEUS parameters from time-intensity curves (TICs) on the hepaticparenchyma, the two regions of interests (ROIs) were located in the right hepatic vein (RHV) territory and middle hepaticvein (MHV) territory of the right hepatic graft. The measured CEUS parameters were wash-in slope (WIS), peak intensity(PI), time to peak (TTP), and area under the curve (AUC). The subjects were classified into the occlusion and non-occlusiongroups. In each group, the parameters measured in the RHV and MHV territories were compared with paired-sample Student'st-tests. Hepatic venous occlusion was diagnosed in 25 patients (54%). The WIS, TTP, and AUC of the MHV territory(2.95 dB/sec; 22.39 sec; 204.27 dB·sec, respectively) were significantly different from those of the RHV territory (2.16 dB/sec; 25.81 sec; 165.66 dB·sec; all p<0.05). There were no statistically significant differences in PI between the MHV and RHVterritories (19.08 dB vs. 18.27 dB, respectively; p=0.259). In the non-occlusion group, there was no parameter which wassignificantly different between MHV and RHV territories (p>0.05). The parametric analysis of CEUS can helpdiagnose middle hepatic venous occlusion after LDLT.