Radiology, Vol 187, 165-170, Copyright © 1993 by Radiological Society of North America
Anatomic features of reduced-size liver transplant: postsurgical imaging characteristics
TE Ben-Ami, V Martich, DK Yousefzadeh, PF Whitington and JC Emond
Department of Radiology, University of Chicago, Pritzker School of Medicine, IL 60637.
In this retrospective review, the authors evaluated the anatomic and
imaging features of 140 reduced-size liver transplants in 120 boys and
girls; 100 of these patients (83.3%) were 2 years old or younger. The
authors reviewed the surgical reports, plain radiographs, contrast
material-enhanced studies of the gastrointestinal tract, duplex Doppler and
color Doppler ultrasound (US) scans, and computed tomographic (CT) scans.
Understanding the anatomic features associated with transplantation was
crucial to understanding the post-surgical imaging characteristics. Changes
in visceral anatomic structure caused a variety of imaging appearances,
some of them misleading: (a) Some patients had unusual bowel gas patterns
on plain radiographs because of a shift in location by bowel loops; (b)
gastrointestinal studies showed gastric compression by an oversized left
lobe that mimicked mass effect; and (c) displacement or migration of the
duodenum, jejunum, or cecum into the right hepatic fossa sometimes mimicked
malrotation. Pitfalls were created by fluid and gas collections at the
transected edge. US and CT were often used to further assess anatomic
structures after surgery; color Doppler was especially helpful in vascular
localization.
