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Detection of Vascular Complications After Liver Transplantation

Early Experience in Multislice CT Angiography with Volume Rendering

¹ All authors: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213.

View larger version (101K): [in a new window]   Fig. 1A. —46-year-old man with highgrade hepatic artery stenosis after liver transplantation. Right posterior oblique volume-rendered three-dimensional multislice CT angiogram shows severe stenosis (arrow) of graft at anastomosis of graft with donor hepatic artery.

View larger version (114K): [in a new window]   Fig. 1B. —46-year-old man with highgrade hepatic artery stenosis after liver transplantation. Catheter angiogram of supraceliac aortic graft reveals high-grade stenosis at anastomosis (arrow).

View larger version (107K): [in a new window]   Fig. 2A. —50-year-old man with increasing levels of liver enzymes suggestive of possible hepatic artery stenosis after liver transplantation. Selective catheter angiogram of recipient hepatic artery shows redundant hepatic artery. Redundancy at anastomosis (arrow) limits evaluation for possible stenosis.

View larger version (103K): [in a new window]   Fig. 2B. —50-year-old man with increasing levels of liver enzymes suggestive of possible hepatic artery stenosis after liver transplantation. Inferior oblique volume-rendered three-dimensional multislice CT angiogram shows tortuous donor hepatic artery-to-recipient hepatic artery anastomosis (arrow) with no evidence of stenosis.

View larger version (105K): [in a new window]   Fig. 3A. —55-year-old man with clinical evidence of decreased hepatic arterial flow and normal findings on Doppler sonography after liver transplantation. Inferior oblique volume-rendered three-dimensional multislice CT angiogram shows occluded hepatic arterial (HA) stump (arrow) with intrahepatic collateral (collater) vessels from left gastric artery.

View larger version (134K): [in a new window]   Fig. 3B. —55-year-old man with clinical evidence of decreased hepatic arterial flow and normal findings on Doppler sonography after liver transplantation. Catheter angiogram of recipient celiac axis confirms occluded hepatic arterial stump (arrow) with filling of proximal left gastric (arrowheads) and splenic arteries. Intrahepatic collateral vessels from left gastric artery are not visualized on celiac injection.

View larger version (105K): [in a new window]   Fig. 4A. —46-year-old man with incidental hepatic artery pseudoaneurysm reported on routine helical CT performed for possible abscess after liver transplantation. Inferior oblique volume-rendered three-dimensional multislice CT angiogram shows right hepatic artery pseudoaneurysm (arrow).

View larger version (113K): [in a new window]   Fig. 4B. —46-year-old man with incidental hepatic artery pseudoaneurysm reported on routine helical CT performed for possible abscess after liver transplantation. Selective catheter angiogram of recipient main hepatic artery confirms pseudoaneurysm of right hepatic artery (arrow).

View larger version (126K): [in a new window]   Fig. 5A. —50-year-old man who presented with sonographic evidence of portal venous stenosis after liver transplantation. Left posterior oblique volume-rendered three-dimensional multislice CT angiogram of portal vein shows moderate stenosis of lower anastomosis of iliac vein graft (arrow).

View larger version (153K): [in a new window]   Fig. 5B. —50-year-old man who presented with sonographic evidence of portal venous stenosis after liver transplantation. Transhepatic portal venogram confirms moderate stenosis (arrow) of lower anastomosis and widely patent upper portal anastomosis at liver hilum.

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