Multislice spiral CT angiography in evaluation of liver transplantation candidates

Abstract

Background: Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. This study was designed to study whether multislice spiral CT angiography (MSCTA) could be used for preoperative evaluation for orthotopic liver transplantation candidates.

Methods: Eighty consecutive potential candidates for liver transplantation were evaluated with dual-phase three-dimensional CT angiography (3DCTA). The arterial-phase was used to create vascular maps of the celiac axis (including the origin of the hepatic common artery, left gastric artery and splenic artery) and origin of the superior mesenteric artery. The portal venous-phase was used to analyze portal vein thrombosis and collateral vascularization of the portal vein. Statistical analyses were made using the chi-square test for differences between hepatic arterial anatomy of 80 patients and Michel's type I anatomy of 200 patients. Appearance of MSCTA and operative results of 16 patients were analyzed.

Results: Sixty-two patients (77.5%) showed conventional and 18 (22.5%) nonconventional hepatic arterial anatomy. A significant difference was found between the two groups in anatomy of the hepatic artery (P<0.05). Celiac axis stenosis was observed in 6 patients, SA aneurysm in 2, small-caliber hepatic arterial vessels in 2, and portal vein thrombosis in 15. Vascular structures of 16 operative patients were well defined.

Conclusion: As a noninvasive examination, MSCTA can provide a comprehensive preoperative vascular evaluation for liver transplantation candidates.