Bedside color and pulse Doppler(duplex)ultrasound for evaluating post orthotopic liver transplantation complications
Objective To explore the value of bedside color and pulse Doppler(duplex)ultrasound for evaluating post orthotopic liver transplantation(OLT)complications.Methods Data of 65 patients who underwent OLT and bedside abdominal duplex ultrasound were retrospectively analyzed.On the first day,the third day and seventh day post OLT,hepatic parenchymal echo and blood flow tracts such as proper hepatic artery and portal vein were observed,portal venous peak velocity(PVPV),peak systolic velocity(PSV)and resistance index(RI)of graft portal hepatic artery were measured.According to abdominal enhanced CT,CT angiography(CTA),contrast-enhanced ultrasound(CEUS),clinical intervention(including immunosuppressant enhancement and secondary transplantation)or pathological results,receiver operating characteristic(ROC)curve was drawn,and area under the curve(AUC)was calculated to evaluate the efficacy of PSV(PSV7th day)and RI(RI7th day)in the first week after OLT for diagnosing OLT complications.Results For all 65 cases,on the first day,the third day and seventh day after OLT,PVPV was 71.00(45.50,96.50),57.50(42.00,71.00)and 50.00(33.00,66.00)cm/s,respectively,RI was 0.68±0.16,0.69±0.17 and 0.66±0.13,respectively,both were not significantly different among different time points(H=5.475,P=0.065;F=0.964,P=0.501).Meanwhile,PSV was 63.00(44.50,89.00),47.00(31.50,64.50)and 50.00(38.25,64.75)cm/s,respectively,being significantly different among different time points(H=7.313,P=0.026).One week after OLT,normal PSV was found in 46 cases,while decreased PSV(＜25 cm/s)and increased PSV(＞100 cm/s)was noticed in 1 and 18 cases,respectively,whereas normal RI,decreased RI(＜0.5)and increased RI(＞0.7)was noticed in 18,11 and 36 cases,respectively.Post OLT complications occurred in 36 cases.AUC of PSV7thday for diagnosing post OLT complications was 0.561,of RI7th day was 0.699,and of PSV7thday combined with RI7thday was 0.732,and the latter was not significantly different with AUC of RI7thday alone(Z=0.290,P＞0.05).Conclusion Bedside duplex ultrasound could be used to monitor arterial flow signals and transplanted hepatic artery RI after OLT,hence effectively diagnose post OLT complications.
万方数据
维普
