USE OF DOPPLER SONOGRAPHY FOR REVEALING HEPATIC-ARTERY STENOSIS IN LIVER-TRANSPLANT RECIPIENTS

OBJECTIVE. The goal of our study was to evaluate the use of duplex Dop pler sonography for revealing hepatic artery stenosis (HAS) in patient s who have undergone Liver transplantation. MATERIALS AND METHODS. For ty-six patients with spectral Doppler waveforms obtained from the hepa tic artery and with subsequent arteriography were reviewed retrospecti vely. Arterial waveforms, resistive indexes (RIs), and systolic accele ration times (SATs) were evaluated by one reviewer who was unaware of the arteriographic findings. The mean interval between the two examina tions was 2.8 days. Arteriograms that revealed a stenosis of greater t han 50% were classified as abnormal. RESULTS. Of the 46 patients, 21 ( 46%) had a significant stenosis. Patients who had HAS had significantl y (p < .05) prolonged SATs (0.08 +/- 0.03 sec versus 0.06 +/- 0.02 sec ) and reduced RIs (0.49 +/- 0.05 Versus 0.66 +/- 0.05) compared with p atients who did not have HAS. Optimal thresholds for HAS detection wer e RIs less than 0.55 and SATs greater than 0.08 sec. HAS was found in 14 of 15 patients who had both abnormal RIs and SATs. Of the remaining 31 patients, 12 had abnormal values for RI or SAT. Of these 12 patien ts, three had HAS. Thus, 19 patients had normal Rls and SATs; however, four of these patients were found to have an arterial stenosis. In ou r 46 patients, abnormal values for both RI and SAT were 67% sensitive and 96% specific for stenosis. When at least one abnormal value was fo und on Doppler imaging, sensitivity and specificity for stenosis were 81% and 60%, respectively. CONCLUSION. Duplex Doppler imaging can noni nvasively reveal HAS. Abnormal values for both RI and SAT proved to be a more accurate predictor of stenosis than either RI or SAT as indepe ndent parameters.