INTRAVENOUS SPIRAL CT ANGIOGRAPHY FOR ASS ESSMENT BEFORE ORTHOTOPIC LIVER-TRANSPLANTATION - COMPARISON BETWEEN TOMOGRAPHY, MIP, 3-DIMENSIONAL SURFACE IMAGING AND INTRAARTERIAL DSA

Purpose: To analyse the efficacy of intravenous spiral CT angiography (SCTA) for the evaluation before orthotopic liver transplantation (oLT ) compared with DSA. Methods: Spiral CT was performed on 31 potential recipients of a liver graft in order to examine hepatic vessels, coeli ac axis, splenic artery and superior mesenteric artery. The arterial v essels were reconstructed in ''Maximum Intensity Projection (MIP)'' an d ''Shaded Surface Display (SSD)''-technique. The axial images, MIP an d SSD were compared in 25 patients with DSA with regard to the visuali sation of the vascular anatomy, detectability of stenosis and vascular diameters. Results: The type of arterial liver supply could be determ ined via SCTA in all patients. Stenosis of the coeliac axis was seen i n ten patients on the DSA, MIP and SSD and in eight patients on the ax ial images. Occlusion of the hepatic artery was clearly visualised in two patients on the DSA, axial images and MIP and in one patient on th e SSD. There was no false positive diagnosis with SCTA. SSD was seen a s the best technique to visualise the vessels without overshadowing. T here were no significant differences between the diameters measured fr om the axial images, MIP and SSD images in transversal direction and t he DSA images (9 >0.05). Conclusion: SCTA is a greatly promising metho d for the imaging of vessels supplying the liver before oLT, and may c onvey more diagnostic information than DSA.