活体肝移植术后受体胆系并发症的影响因素及影像学表现  

Biliary complications in recipients after living donor liver transplantation: influencing factors and imaging manifestations

作　　者：刘曦娇[1] 李嘉鑫 黄子星[1] 陈光文[3] 李晨[2] 宋彬[1] 

机构地区：[1]四川大学华西医院放射科,四川省成都市610041 [2]四川大学华西临床医学院,四川省成都市610041 [3]四川省人民医院放射科,四川省成都市610041

出　　处：《世界华人消化杂志》2011年第25期2688-2692,共5页World Chinese Journal of Digestology

基　　金：四川省科技厅公益基金资助项目;No.2008FG0011~~

摘　　要：目的:探讨活体肝移植(LDLT)术后受体胆系并发症发生的影响因素及其影像学表现.方法:纳入2007-01/2011-03在我院接受活体肝移植的患者119例,回顾性分析其在术后随访的多层螺旋CT(MDCT)及MRI图像,重点观察胆道系统,观察有无各种胆系并发症,必要时结合各种后处理技术,包括多平面重建、最大密度投影等.将结果与其同期随访的临床及其他辅助检查对照,并探讨其发生原因.结果:119例患者术后1-18mo随访中,胆系并发症共计22例,发生率约18.5%.其中包括9例胆汁淤积、5例胆管炎、4例胆管狭窄和4例胆漏.各种并发症的主要发生时间不一致,发生的影响因素复杂.胆汁淤积、胆管炎及胆管狭窄在MDCT、MRI图像上可良好显示,并有各自的影像学特点,MRI价值大于MDCT.目前两种检查技术对胆漏的诊断价值有限.结论:LDLT术后胆系并发症发生的解剖生理复杂,影像学价值大,其中MRI优于MDCT.建议临床医生在LDLT受体术后随访时如怀疑有胆系并发症首选MRI检查.AIM： To investigate the influencing factors for and imaging manifestations of biliary complications in patients after living donor liver transplantation （LDLT）.METHODS： The imaging data for 119 patients who underwent LDLT at West China Hospital from January 2007 to March 2011 were retrospectively analyzed. All biliary system images were read and analyzed independently by two radiologists.RESULTS： A total of 119 patients were followed up for 1-18 months. During the follow-up period, 22 patients developed biliary complications, including 9 cases of cholestasis, 5 cases of cholangitis, 4 cases of stenosis, and 4 cases of bile leakage. Different complications occurred at different time points. Multidetector computed tomography （MDCT） and magnetic resonance imaging （MRI） can display cholestasis, cholangitis and biliary stenosis well, and MRI has greater diagnostic value than MDCT. Both methods had limited value in the diagnosis of bile leakage.CONCLUSION： The influencing factors for biliary complications in recipients after LDLT are diverse. MDCT and MRI have great value in the detection of these complications.

关 键 词：活体肝移植 术后并发症 胆系 影像学 

分 类 号：R657.3[医药卫生—外科学]