Vascular complications in liver transplantation: Beneficial role of contrast-enhanced ultrasound (CEUS) in the postoperative phase

PURPOSE: To compare the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and computed tomography (CT) in the diagnosis of vascular complications after liver transplantation in the postoperative phase. MATERIALS AND METHODS: A total of 60 patients with elevated liver function tests after liver transplantation with initial imaging studies between July 2005 and November 2015 were retrospectively analysed. CEUS and CT were compared in their diagnosis of vascular complications and CT was considered as the gold standard. Out of 60 patients 28 patients showed vascular complications in CT, which could also be detected in 25 out 28 of cases using CEUS. Diagnostic accuracy was tested by using the CT diagnosis as the gold standard. RESULTS: CEUS showed a sensitivity of 89.3%, a specificity of 100.0%, a positive predictive value (PPV) of 100.0% and a negative predictive value (NPV) of 91,4% compared to CT as the gold standard. In 3 cases CT showed a vascular complication, whereas the CEUS examination was reported as normal. CONCLUSION: CEUS is a fast, non-ionizing imaging modality for the initial exclusion of vascular complications after liver transplantation. CEUS shows a high specificity and PPV in the detection of vascular complications. In unclear cases CT still is considered as the gold standard.