Display options
Cite
Zheng BW, Yi SH, Wu T, et al. CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture. Clin Hemorheol Microcirc. 2021;79(4):519-530doi: 10.3233/CH-211097.
Zheng, B. W., Yi, S. H., Wu, T., Liao, M., Zhang, Y. C., Yuan, L. X., Zheng, R. Q., Yang, Y., & Ren, J. (2021). CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture. Clinical hemorheology and microcirculation, 79(4), 519-530. https://doi.org/10.3233/CH-211097
Zheng, Bo-Wen, et al. "CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture." Clinical hemorheology and microcirculation vol. 79,4 (2021): 519-530. doi: https://doi.org/10.3233/CH-211097
Zheng BW, Yi SH, Wu T, Liao M, Zhang YC, Yuan LX, Zheng RQ, Yang Y, Ren J. CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture. Clin Hemorheol Microcirc. 2021;79(4):519-530. doi: 10.3233/CH-211097. PMID: 34366329.
Copy Download .nbib Format: NLM
Share it on

Clin Hemorheol Microcirc. 2021;79(4):519-530. doi: 10.3233/CH-211097.

CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture.

Clinical hemorheology and microcirculation

Bo-Wen Zheng, Shu-Hong Yi, Tao Wu, Mei Liao, Ying-Cai Zhang, Lian-Xiong Yuan, Rong-Qin Zheng, Yang Yang, Jie Ren

Affiliations

  1. Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People's Republic of China.
  2. Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People's Republic of China.
  3. Department of Scientific Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, People's Republic of China.

PMID: 34366329 DOI: 10.3233/CH-211097

Abstract

BACKGROUND: Biliary ischaemia is an important factor in the pathogenesis of non-anastomotic biliary stricture (NAS) after liver transplantation (LT). Contrast-enhanced ultrasound (CEUS) can be used to detect biliary ischaemia, but no study has examined the utility of CEUS in predicting NAS.

OBJECTIVE: To evaluate whether repeated CEUS as a non-invasive method of biliary ischaemia can identify NAS.

METHODS: Consecutive LT patients who underwent CEUS examinations at 1-4 weeks after LT from September 2012 to December 2015 at our institution were included. The CEUS images and clinical data were analysed.

RESULTS: Among 116 eligible LT patients, 39 (33.6%) were diagnosed with NAS within 1 year after LT. The patients with NAS had a significantly higher CEUS score at weeks 2-4 (all P < 0.05) and a higher slope of CEUS score progression (0.480 vs -0.044, P < 0.001). The accuracy of CEUS in identifying NAS improved over time after LT, reaching its maximum at week 4, with a sensitivity of 66.7%, a specificity of 87.9%, a positive predictive value (PPV) of 75.9%, a negative predictive value (NPV) of 82.3%, and an accuracy of 80.2%in the full cohort when a CEUS score≥3 was used as the cut-off. Multivariate analysis identified gamma-glutamyl transpeptidase (GGT), alanine transaminase (ALT) and the CEUS score at week 4 as independent predictors of NAS. In the task of identifying NAS, an NAS score combining the above 3 variables at week 4 showed areas under the receiver operating characteristic curve of 0.88 (95%CI, 0.78-0.99) in the estimation group (n = 60) and 0.82 (95%CI, 0.69-0.96) in the validation group (n = 56). An NAS score cut-off of 0.396 identified 87.2%of NAS cases in the estimation group, with a PPV of 93.3%; and 75.0%of NAS cases in the validation group, with a PPV of 58.8%.

CONCLUSIONS: CEUS examination during the first 4 weeks is useful in assessing the risk of NAS within 1 year after LT. In particular, an NAS score combining the CEUS score, GGT level, and ALT level at week 4 can be used to accurately predict the risk of NAS in LT patients.

Keywords: Ultrasonography; biliary tract diseases; contrast agent BR1; ischemia; liver transplantation; microcirculation

Publication Types