HEPATIC-ARTERY THROMBOSIS AFTER LIVER-TRANSPLANTATION - DIAGNOSIS WITH SPIRAL CT

OBJECTIVE. The purpose of this study was to prospectively evaluate spi ral CT with maximum-intensity projection in the diagnosis of hepatic a rtery thrombosis in patients with liver transplants. SUBJECTS AND METH ODS. Thirty liver transplant recipients (19 men, 11 women; mean age, 4 9 years) underwent Doppler sonography and spiral CT with maximum-inten sity projection to evaluate both hepatic parenchyma and hepatic vessel s. In five cases, these examinations were followed by angiography for suspected hepatic artery thrombosis. RESULTS. Among the 30 patients, r esults of both Doppler sonography and spiral CT were abnormal in five patients. In all five patients, Doppler sonography revealed an absence of intrahepatic arterial signal (sensitivity, 100%). Spiral CT showed the hepatic artery to be patent from its origin to the anastomosis an d then occluded distally in four patients and showed occlusion of the entire hepatic artery in one patient (sensitivity, 100%). Aortography and/or selective arteriography of the celiac axis confirmed the diagno sis of hepatic artery thrombosis in all five cases. The other 25 patie nts had a normal clinical outcome, 24 with normal findings on Doppler sonograms (specificity, 96%), and 23 with normal findings on spiral CT . Two patients had false-positive CT studies because of technical fail ures (specificity, 92%). CONCLUSION. Spiral CT with maximum-intensity projection is highly accurate in identifying hepatic artery thrombosis after liver transplantation.