الفهرس 
NORMAL APPEARANCE OF VASCULAR AND BILIARY STRUCTURES AFTER LIVER TRANSPLANTATIONOnly 14 pages are availabe for public view
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Abstract
Liver transplantation has become widely accepted and is the mainstay therapy for multiple acute and chronic liver diseases, fulminant liver failure, metabolic disease, and selected cases of HCC (unresectable but local HCC). Survival after transplantation has been improved owing to advances in immunosuppressive therapy and surgical techniques that allow the patients to live many years after transplantation. Nevertheless, postoperative complications contribute significantly to the morbidity and mortality of liver transplant recipients; therefore postoperative imaging surveillance is important in minimizing the impact of complications and maximizing both graft and patient survival. With the introduction of MDCT, the post-liver transplant evaluation is changing rapidly.
MDCT was first introduced in 1998. It is the most recent advance in CT technology. An increased number of detector rows and more powerful x-ray tubes results in faster scanning time, increased volume coverage, narrower collimation, improved spatial, contrast and temporal resolution, and near isotropic data acquisition. Compared with SDCT, MDCT technology allows superior image quality and the ability to produce isotropic high-quality multiplanar images and to perform complex multiphase vascular and 3-D examinations.
Although US is usually the initial imaging modality used for evaluation of post-liver transplant evaluation as it is an accessible bed-side procedure, it is operator-dependent and produces a significant frequency of false-negative results which are therefore sometimes inconclusive necessitating the use of MDCT with CT angiography.
MDCT with CT angiography is already widely acknowledged to be superior to US in the detection of vascular complications and in the evaluation of the hepatic parenchyma and the extrahepatic tissues. It plays a major role in the identification and managements of abnormal fluid collections, such as abscesses, hematomas and bilomas. CT is usually the test of choice in excluding recurrent or metastatic tumours, as well as cyclosporine-induced lymphoproliferative disorders.
The advances in MDCT have given the radiologist unique imaging capabilities that provide the opportunity to revolutionize how we image and evaluate patients for a wide range of clinical indications. The ability to provide a non-invasive examination at much less the cost of a more invasive study with equal or greater ease of use is a very exciting development in imaging.
The following conclusions were derived from the study:
1. MDCT is a safe, non-invasive, accurate, and reliable imaging tool for evaluation of post-liver transplant recipients.
2. MDCT has considerable diagnostic accuracy.
3. MDCT allows complete imaging of the hepatic and extrahepatic tissues.
4. MDCT carries the advantages of being a short time procedure and of high spatial resolution.
5. 3-dimensional CT angiography allows excellent depiction of vascular structures, not only for gross patency but also for stenoses.
6. Contrast-enhanced MDCT produces a good non-invasive alternative to conventional angiography.