Contrast-enhanced ultrasound of liver lesions related to arterial thrombosis in adult liver transplantation

ABSTRACTPurpose To describe the contrast-enhanced ultrasound (CEUS) features of liver and biliary lesions related to hepatic artery thrombosis in adult patients with orthotopic liver transplantation. Methods Gray-scale ultrasound (US), Doppler US, and CEUS using a hexafluoride-based US contrast media were performed on a series of eight patients with liver transplantation and hepatic artery thrombosis. Results Six of the cases presented infarctions, seen as parenchymal geographic areas of lack of enhancement. Biliary necrosis, seen as nonenhancing periportal cuff, was seen in one case. Infected biloma, seen as a nonenhancing hilar collection, was present in two cases. Infarction and biloma coexisted in one patient. Two abscesses were seen as a late complication in one case. One of them was seen as a typical necrotic abscess with a central nonenhancing area and peripheral rim enhancement higher than the surrounding liver. The other one was seen as a partially liquefied abscess. Conclusion CEUS was useful to diagnose lesions related to hepatic artery thrombosis in liver transplantation. It enabled distinguishing between them and to define their size and extension better than conventional gray-scale US. (c) 2013 Wiley Periodicals, Inc. J Clin Ultrasound, 41:493-500, 2013;