Ultrasonography.  2015 Jan;34(1):58-65. 10.14366/usg.14038.

UltraFast Doppler ultrasonography for hepatic vessels of liver recipients: preliminary experiences

• Hur BY
• Lee JY
• Chu AJ
• Kim SH
• Han JK
• Choi BI

• KMID: 2382032
• DOI: http://doi.org/10.14366/usg.14038

Abstract

PURPOSE
The purpose of this study was to investigate the value of UltraFast Doppler ultrasonography (US) for evaluating hepatic vessels in liver recipients.
METHODS
Thirty-nine liver Doppler US sessions were conducted in 20 liver recipients. Each session consisted of UltraFast and conventional liver Doppler US in a random order. We compared the velocities and phasicities of the hepatic vessels, duration of each Doppler study, occurrence of technical failures, and differences in clinical decisions.
RESULTS
The velocities and resistive index values of hepatic vessels showed a strong positive correlation between the two Doppler studies (mean R=0.806; range, 0.710 to 0.924). The phasicities of the hepatic vessels were the same in both Doppler US exams. With respect to the duration of the Doppler US exam, there was no significant difference between the UltraFast (251+/-99 seconds) and conventional (231+/-117 seconds) Doppler studies (P=0.306). In five poor breath-holders, in whom the duration of conventional Doppler US was longer, UltraFast Doppler US (272+/-157 seconds) required a shorter time than conventional Doppler US (381+/-133 seconds; P=0.005). There was no difference between the two techniques with respect to technical failures and clinical decisions.
CONCLUSION
UltraFast Doppler US is clinically equivalent to conventional Doppler US with advantages for poor breath-holders during the post-liver transplantation work-up.

Keyword

Doppler ultrasonography; Liver; Liver transplantation

MeSH Terms

Liver Transplantation
Liver*
Ultrasonography, Doppler*

Reference

References

1. Singh AK, Nachiappan AC, Verma HA, Uppot RN, Blake MA, Saini S, et al. Postoperative imaging in liver transplantation: what radiologists should know. Radiographics. 2010; 30:339–351.

2. Mullan CP, Siewert B, Kane RA, Sheiman RG. Can Doppler sonography discern between hemodynamically significant and insignificant portal vein stenosis after adult liver transplantation? AJR Am J Roentgenol. 2010; 195:1438–1443.

3. Adam R, Karam V, Delvart V, O'Grady J, Mirza D, Klempnauer J, et al. Evolution of indications and results of liver transplantation in Europe: a report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012; 57:675–688.

4. Adam R, McMaster P, O'Grady JG, Castaing D, Klempnauer JL, Jamieson N, et al. Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry. Liver Transpl. 2003; 9:1231–1243.

5. Hwang S, Lee SG, Belghiti J. Liver transplantation for HCC: its role: Eastern and Western perspectives. J Hepatobiliary Pancreat Sci. 2010; 17:443–448.

6. Russo MW, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver transplantation for acute liver failure from drug induced liver injury in the United States. Liver Transpl. 2004; 10:1018–1023.

7. Marcos A. Right lobe living donor liver transplantation: a review. Liver Transpl. 2000; 6:3–20.

8. Wozney P, Zajko AB, Bron KM, Point S, Starzl TE. Vascular complications after liver transplantation: a 5-year experience. AJR Am J Roentgenol. 1986; 147:657–663.

9. Tamsel S, Demirpolat G, Killi R, Aydin U, Kilic M, Zeytunlu M, et al. Vascular complications after liver transplantation: evaluation with Doppler US. Abdom Imaging. 2007; 32:339–347.

10. De Gaetano AM, Cotroneo AR, Maresca G, Di Stasi C, Evangelisti R, Gui B, et al. Color Doppler sonography in the diagnosis and monitoring of arterial complications after liver transplantation. J Clin Ultrasound. 2000; 28:373–380.

11. Broelsch CE, Malago M, Testa G, Valentin Gamazo C. Living donor liver transplantation in adults: outcome in Europe. Liver Transpl. 2000; 6(6 Suppl 2):S64–S65.

12. Park YS, Kim KW, Lee SJ, Lee J, Jung DH, Song GW, et al. Hepatic arterial stenosis assessed with Doppler US after liver transplanta tion: frequent false-positive diagnoses with tardus parvus waveform and value of adding optimal peak systolic velocity cutoff. Radiology. 2011; 260:884–891.

13. Choi EK, Lu DS, Park SH, Hong JC, Raman SS, Ragavendra N. Doppler US for suspicion of hepatic arterial ischemia in orthotopically transplanted livers: role of central versus intrahepatic waveform analysis. Radiology. 2013; 267:276–284.

14. Garcia-Criado A, Gilabert R, Berzigotti A, Bru C. Doppler ultrasound findings in the hepatic artery shortly after liver transplantation. AJR Am J Roentgenol. 2009; 193:128–135.

15. Huang TL, Cheng YF, Chen TY, Tsang LL, Ou HY, Yu CY, et al. Doppler ultrasound evaluation of postoperative portal vein stenosis in adult living donor liver transplantation. Transplant Proc. 2010; 42:879–881.

16. Zalasin S, Shapiro RS, Glajchen N, Stancato-Pasik A. Liver transplant rejection: value of hepatic vein Doppler waveform analysis. Abdom Imaging. 1998; 23:427–430.

17. Nishida S, Kato T, Levi D, Naveen M, Thierry B, Vianna R, et al. Effect of protocol Doppler ultrasonography and urgent revascularization on early hepatic artery thrombosis after pediatric liver transplantation. Arch Surg. 2002; 137:1279–1283.

18. Gilabert R, Bargallo X, Forns X, Bru C, Rimola A, Salmeron JM, et al. Value of duplex-doppler ultrasound findings in liver transplant recipients with poor graft function. Transplantation. 1996; 61:832–835.

19. Kok T, Slooff MJ, Thijn CJ, Peeters PM, Verwer R, Bijleveld CM, et al. Routine Doppler ultrasound for the detection of clinically unsuspected vascular complications in the early postoperative phase after orthotopic liver transplantation. Transpl Int. 1998; 11:272–276.

20. Someda H, Moriyasu F, Fujimoto M, Hamato N, Nabeshima M, Nishikawa K, et al. Vascular complications in living related liver transplantation detected with intraoperative and postoperative Doppler US. J Hepatol. 1995; 22:623–632.

21. Stange BJ, Glanemann M, Nuessler NC, Settmacher U, Steinmuller T, Neuhaus P. Hepatic artery thrombosis after adult liver transplantation. Liver Transpl. 2003; 9:612–620.

22. Coulden RA, Britton PD, Farman P, Noble-Jamieson G, Wight DG. Preliminary report: hepatic vein Doppler in the early diagnosis of acute liver transplant rejection. Lancet. 1990; 336:273–275.

23. Stell D, Downey D, Marotta P, Solano E, Khakhar A, Quan D, et al. Prospective evaluation of the role of quantitative Doppler ultrasound surveillance in liver transplantation. Liver Transpl. 2004; 10:1183–1188.

24. Montaldo G, Tanter M, Bercoff J, Benech N, Fink M. Coherent planewave compounding for very high frame rate ultrasonography and transient elastography. IEEE Trans Ultrason Ferroelectr Freq Control. 2009; 56:489–506.

25. Bercoff J. UltraFast ultrasound imaging. Rijeka: InTech;2011.

26. Bercoff J, Montaldo G, Loupas T, Savery D, Meziere F, Fink M, et al. UltraFast compound Doppler imaging: providing full blood flow characterization. IEEE Trans Ultrason Ferroelectr Freq Control. 2011; 58:134–147.

27. Udesen J, Gran F, Hansen KL, Jensen JA, Thomsen C, Nielsen MB. High frame-rate blood vector velocity imaging using plane waves: simulations and preliminary experiments. IEEE Trans Ultrason Ferroelectr Freq Control. 2008; 55:1729–1743.