Clinical use of Levovist, an ultrasound contrast agent, in the imaging of liver transplantation: assessment of the pre- and post-transplant patient

Colour Doppler US is well established for imaging bf hepatic vessels in the assessment of pre- and post-liver transplant patients. Unfortunately, a co le Doppler US examination of the portal or hepatic venous and hepatic arter ial systems is frequently precluded by technical factors. Ultrasound contra st agents are useful in enhancing vascular Doppler signal and play an impor tant role in liver transplantation assessment. A series of patients with va scular problems illustrates the role of US contrast in the pre-transplant c andidate, where portal vein patency and direction of flow is assessed, pres ence of portal vein thrombus is confirmed and cavernous transformation demo nstrated. Occlusion of hepatic veins in Budd-Chiari syndrome is confidently confirmed. Following liver transplantation. US contrast allows a comprehen sive assessment of hepatic artery thrombosis, hepatic artery stenosis and p seudoaneurysm formation. The need for further imaging is reduced or confide ntly deferred in many instances. Ultrasound contrast agents play an importa nt role in the liver transplant candidate.