Hepatic artery stenosis and thrombosis in transplant recipients: Doppler diagnosis with resistive index and systolic acceleration time

Abstract

Purpose: To assess the value of resistive index (RI) and systolic acceleration time (SAT) for diagnosis of stenoses and thromboses of the hepatic artery in liver transplant recipients.

Materials and methods: Doppler sonograms and angiograms in 125 liver transplant recipients were correlated and analyzed for any statistically significant difference in the RI or SAT of patients with and without arterial stenosis or thrombosis. Sensitivity and specificity were calculated for RI, SAT, peak arterial systolic velocity, and absence of arterial flow.

Results: Forty-seven patients had a marked stenosis; 16 had thrombosis. There was a statistically significant difference (P < .05) in the RI and SAT of patients with stenosis or thrombosis versus those with normal arteries but not in patients with stenosis versus thrombosis. RI and SAT parameters allowed detection of abnormalities not found with peak velocity and no-flow parameters. Combined parameters produced 97% sensitivity and 64% specificity for marked arterial disease.

Conclusion: Doppler spectral wave form analysis provides excellent screening for detection of hepatic allograft arterial stenosis or thrombosis.