A group led by Dr. Jin Sil Kim of Ewha Womans University School of Medicine in Seoul, South Korea, assessed 1,246 adult liver transplant recipients with 1,320 grafts performed between January 2014 and February 2017.
Of the total number of grafts, 132 in 130 recipients were suspected of having hepatic artery obstruction on Doppler ultrasound; 21 of these were excluded because neither CEUS nor CTA exams were performed within 24 hours of the artery obstruction diagnosis. Of the 111 remaining grafts, 68 were identified on CEUS, 91 on CTA, and 48 on both.
Both modalities showed comparable performance, although CEUS found two hepatic artery obstructions that CTA missed, and CTA found one that CEUS missed:
- Sensitivity: CEUS, 94.7%; CTA, 92.9%
- Specificity: CEUS, 93.9%; CTA 91%
- Positive predictive value: CEUS, 85.7%; CTA, 86.7%
- Negative predictive value: CEUS, 97.9%; CTA, 96.7%
- Accuracy: CEUS, 94.1%; CTA, 93.4%
What's the bottom line? Physicians can use either of these exams with confidence to diagnose hepatic artery obstruction, the researchers wrote.
"Both CEUS and CTA are helpful and complementary tools for the diagnosis of significant hepatic artery obstruction in recipients with suspected ... obstruction on Doppler ultrasound," they concluded.
