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Published online before print March 15, 2005, 10.1148/radiol.2352040506
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Acute Liver Rejection: Accuracy and Predictive Values of Doppler US Measurements—Initial Experience1

Massimo Bolognesi, MD, PhD, David Sacerdoti, MD, Claudia Mescoli, MD, Valeria Nava, MD, Giancarlo Bombonato, MD, Carlo Merkel, MD, Roberto Merenda, MD, Paolo Angeli, MD, PhD, Massimo Rugge, MD and Angelo Gatta, MD

1 From the Department of Clinical and Experimental Medicine (M.B., D.S., V.N., G.B., C. Merkel, P.A., A.G.), Department of Oncology and Surgical Sciences (C. Mescoli, M.R.), and Institute of General Surgery (R.M.), Clinica Medica 5, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. Received March 17, 2004; revision requested May 25; revision received June 8; accepted July 20. Address correspondence to M.B. (e-mail: massimo.bolognesi@unipd.it).



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  		Figure 1. Bar graph shows percentage changes in the duplex Doppler US parameters detected at liver biopsy. Patients were classified according to RAI score. Graph demonstrates that these Doppler US parameters, particularly the Doppler US composite index, are related to severity of rejection. Although theoretical maximal score for the RAI is 9, patients with clinically relevant acute rejection were assigned scores of 4-6 on the horizontal axis, because 6 was the highest RAI score among patients in this study (Table 1). White bars = percentage changes in PBV, gray bars = percentage changes in SPI, black bars = percentage changes in Doppler US composite index. Results with one-way analysis of variance with posttest for linear trend test each parameter follow: * indicates P = .032; **, P = .055; §, P = .003.

 


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  		Figure 2. Graph shows receiver operating characteristic curves for prediction of acute rejection according to percentage changes in PBV ({diamondsuit}) and of Doppler US composite index calculated by combining the percentage changes in PBV and SPI ({triangleup}). Both parameters (change in PBV and change in SPI) had good accuracy for prediction of acute rejection. Best point of curve was achieved with a percentage decrease cutoff of SPI of –25% (specificity, 89% [16 of 18]; sensitivity, 86% [six of seven]). Dashed line is the line of no diagnostic accuracy.

 




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