磁共振成像在肝移植术后并发症诊断中的应用

目的探讨磁共振成像在肝移植并发症诊断中的价值。方法回顾分析11例肝移植术后发生并发症者的磁共振检查影像资料。结果11例患者术后出现皮肤和巩膜黄染、发热以及尿黄等症状，丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶和胆红素升高．经B型超声波检查不能明确原因，采用磁共振（MRI、MRA和MRCP）检查，明确肝动脉吻合口狭窄1例；肝动脉闭塞2例；下腔静脉吻合口狭窄及血栓形成各1例；胆管吻合口狭窄4例，其中1例伴胆汁瘤形成；肝门水平非吻合口狭窄6例；肝坏死2例；肝包膜下血肿及右肾上腺出血各1例；均显示不等量的右侧胸腔积液、腹腔积液及肝门部水肿。结论磁共振一次检查可显示肝内外的多种结构，能为肝移植术后并发症的诊断提供丰富的肝脏、血管、胆道以及肝外结构的图像信息。

Application of MR imaging in the diagnosis of complications following liver transplantation

Objective To study the value of MR imaging (MRI) in the diagnosis of complications following liver transplantation.Methods The MRI appearances were analyzed retrospectively in 11 patients with complications after liver transplantation.Results Eleven cases had symptoms of skin and sclera jaundice, fever and yellow urine. Alanine transaminase, aspartate transaminase, GGT and bilirubin were increased after liver transplantation. In the patients whose causes of complications were not identified by ultrasonography, MRI,MRA and MRCP showed hepatic arterial anastomotic stenosis (n=1), hepatic arterial occlusion (n=2), inferior vena cava anastomotic stenosis (n=1), thrombosis (n=1), bile duct anastomotic stenosis (n=4), bile duct non-anastomotic stricture at the hepatic porta (n=6), hepatic necrosis (n=2), hepatic subcapsule hematoma (n=1) and right-sided adrenal hemorrhage (n=1). Various amounts of right-sided pleural effusion, ascites and periportal edema were seen in all patients.Conclusion MRI can demonstrate intrahepatic and extrahepatic constructions, and can provide imaging information of liver vessel bile duct and extrahepatic constructions for diagnosis of complications after liver transplantation.