Year 2019 / Volume 111 / Number 5
Review
Meta-analysis of the diagnostic value of contrast-enhanced ultrasound for the detection of vascular complications after liver transplantation

388-396

DOI: 10.17235/reed.2018.5818/2018

Suxian Chen, Xiong Wang, Baoxin Zhang, Baijing Liu, Hui Pan,

Abstract
Background: contrast-enhanced ultrasound (CEUS) is increasingly used to identify vascular complications in patients after liver transplantation. The present study aimed to evaluate the diagnostic accuracy of CEUS using all available data. Materials and methods: relevant studies published before February 2018 were retrieved from PubMed, EMBASE, ScienceDirect and Web of Science. Pooled sensitivity and specificity, diagnostic odds ratio (DOR) and summary receiver operating characteristic curve (SROC) were calculated to estimate the diagnostic performance of CEUS for vascular complications. Sensitivity analysis was performed that stratified studies according to age, study design and sample size in order to determine the influence of these factors on the overall effect. Meta-regression analyses were performed to examine the possible sources of heterogeneity. Quality assessment and publication bias of the included studies were also evaluated. Results: thirteen studies which consisted of 2,781 CEUS cases were included in the analysis. The pooled weighted estimates of sensitivity and specificity were 0.90 (95% CI, 0.84 to 0.95) and 1.00 (95% CI, 1.00 to 1.00), the diagnostic odds ratio (DOR) was 431.96 (95% CI, 164.60 to 1,133.59) and the area under the curve (AUC) of SROC was 0.9741. According to the sensitivity analysis, age, study design and sample size had an insignificant influence on the diagnostic performance of CEUS. The meta-regression analyses did not reveal a strong correlation between CEUS accuracy and study design, treatment time of patients and experience of the radiologists. Conclusion: the results of our meta-analysis showed a high sensitivity, specificity and accuracy of the CEUS modality for the identification of vascular complications in patients after liver transplantation. Since this is the first meta-analysis investigating in this aspect, more evidence is required to validate the clinical utility of CEUS for the identification of vascular complications in patients with a transplanted liver.
Share Button
New comment
Comments
No comments for this article
References
1. Abbasoglu O. Liver transplantation: Yesterday, today and tomorrow. World Journal of Gastroenterology. 2008;14(20):3117-22.
2. Eghtesad B, Aucejo F. Liver transplantation for malignancies. Journal of Gastrointestinal Cancer. 2014;45(3):353-62.
3. Mehrabi A, Fonouni H, Müller SA, et al. Current concepts in transplant surgery: liver transplantation today. Langenbecks Archives of Surgery. 2008;393(3):245-60.
4. Duffy JP, Hong JC, Farmer DG, et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. Journal of the American College of Surgeons. 2009;208(5):896-903.
5. Pawlak J, Grodzicki M, Leowska E, et al. Vascular complications after liver transplantation. Transplantation Proceedings. 2003;35(6):2313-5.
6. Piardi T, Lhuaire M, Bruno O, et al. Vascular complications following liver transplantation: A literature review of advances in 2015. World Journal of Hepatology. 2016;8(1):36-57.
7. Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplantation Proceedings. 2010;42(3):865.
8. Pérez-Saborido B, Pacheco-Sánchez D, Barrera-Rebollo A, et al. Incidence, management, and results of vascular complications after liver transplantation. Transplantation Proceedings. 2011;43(3):749-50.
9. Vaidya S, Dighe M, Kolokythas O, et al. Liver transplantation: vascular complications. Ultrasound Quarterly. 2007;23(4):239-53.
10. Lin M, Qiang L, Yan L. Vascular complications after adult living donor livertransplantation: Evaluation with ultrasonography. World Journal of Gastroenterology. 2016;22(4):1617-26.
11. Perkins JD. Incidence of portal vein complications following liver transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2008;14(12):1813.
12. Singh AK, Nachiappan AC, Verma HA, et al. Postoperative imaging in liver transplantation: what radiologists should know. Radiographics A Review Publication of the Radiological Society of North America Inc. 2010;30(2):339.
13. Roberts JH, Mazzariol FS, Frank SJ, et al. Multimodality Imaging of Normal Hepatic Transplant Vasculature and Graft Vascular Complications. Journal of Clinical Imaging Science. 2011;1:50.
14. García-Criado A, Gilabert R, Nicolau C, et al. Early detection of hepatic artery thrombosis after liver transplantation by Doppler ultrasonography: prognostic implications. J Ultrasound Med. 2001;20(1):51-8.
15. Garcíacriado A, Gilabert R, Berzigotti A, et al. Doppler ultrasound findings in the hepatic artery shortly after liver transplantation. Ajr Am J Roentgenol. 2009;193(1):128-35.
16. Luo Y, Fan YT, Lu Q, et al. CEUS: A new imaging approach for postoperative vascular complications after right-lobe LDLT. World Journal of Gastroenterology. 2009;15(29):3670-5.
17. Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) - update 2008. Ultraschall in der Medizin - European Journal of Ultrasound. 2008;29(01):28-44.
18. Piscaglia F, Bolondi L. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound in Medicine & Biology. 2006;32(9):1369-75.
19. Ter HG. Safety and bio-effects of ultrasound contrast agents. Medical & Biological Engineering & Computing. 2009;47(8):893-900.
20. Lee SJ, Kim KW, Kim SY, et al. Contrast‐enhanced sonography for screening of vascular complication in recipients following living donor liver transplantation. Journal of Clinical Ultrasound. 2013;41(5):305-12.
21. Teegen EM, Denecke T, Eisele R, et al. Clinical application of modern ultrasound techniques after liver transplantation. Acta Radiologica. 2016;57(10):1161-70.
22. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine. 2011;155(8):529-36.
23. Bonini G, Pezzotta G, Morzenti C, et al. Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients. Journal of Ultrasound. 2007;10(2):99-106.
24. Clevert DA, Stickel M, Minaifar N, et al. Contrast-enhanced ultrasound in liver transplant: first results and potential for complications in the postoperative period. Clinical Hemorheology & Microcirculation. 2009;43(1-2):83.
25. García-Criado A, Gilabert R, Bianchi L, et al. Impact of contrast-enhanced ultrasound in the study of hepatic artery hypoperfusion shortly after liver transplantation: contribution to the diagnosis of artery steal syndrome. European Radiology. 2015;25(1):196-202.
26. Hom BK, Shrestha R, Palmer SL, et al. Prospective evaluation of vascular complications after liver transplantation: comparison of conventional and microbubble contrast-enhanced US. Radiology. 2006;241(1):267-74.
27. Huang D, Chen Y, Li K, et al. Hemodynamic changes on color Doppler flow imaging and intravenous contrast-enhanced ultrasound for assessing transplanted liver and early diagnosis of complications. Journal of Huazhong University of Science and Technology (Medical Sciences). 2008;28(3):284-6.
28. Lu Q, Zhong XF, Huang ZX, et al. Role of contrast-enhanced ultrasound in decision support for diagnosis and treatment of hepatic artery thrombosis after liver transplantation. European Journal of Radiology. 2012;81(3):338-43.
29. Lyu SQ, Ren J, Zheng RQ, et al. Contrast‐Enhanced Sonography for Diagnosing Collateral Transformation of the Hepatic Artery After Liver Transplantation. Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine. 2015;34(9):1591-8.
30. Rübenthaler J, Paprottka KJ, Hameister E, et al. Vascular complications in liver transplantation: Beneficial role of contrast-enhanced ultrasound (CEUS) in the postoperative phase. Clinical Hemorheology & Microcirculation. 2016;64(3):1-8.
31. Ren X, Luo Y, Gao N, et al. Common ultrasound and contrast-enhanced ultrasonography in the diagnosis of hepatic artery pseudoaneurysm after liver transplantation. Experimental & Therapeutic Medicine. 2016;12(2):1029-33.
32. Rennert J, Dornia C, Georgieva M, et al. Identification of early complications following liver transplantation using contrast enhanced ultrasound (CEUS). First results. J Gastrointestin Liver Dis. 2012;21(4):407-12.
33. Rübenthaler J, Paprottka KJ, Hameister E, et al. Diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in monitoring vascular complications in patients after liver transplantation - diagnostic performance compared with histopathological results. Clinical Hemorheology & Microcirculation. 2017;66(4):311-316.
34. Zheng RQ, Mao R, Ren J, et al. Contrast-enhanced ultrasound for the evaluation of hepatic artery stenosis after liver transplantation: potential role in changing the clinical algorithm. Liver Transplantation. 2010;16(6):729-35.
35. Zhu XS, Gao YH, Wang SS, et al. Contrast-enhanced ultrasound diagnosis of splenic artery steal syndrome after orthotopic liver transplantation. Liver Transplantation. 2012;18(8):966-71.
36. Zhang J, Yu Y, Li Y, et al. Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016. Oncotarget. 2017;8(43):75418-26.
37. Yang G, Xie LM. Contrast-enhanced ultrasound and contrast-enhanced CT for diagnosis of focal liver lesions:Meta-analysis. Chinese Journal of Medical Imaging Technology. 2009;25(6):1040-2.
38. Friedrich-Rust M, Klopffleisch T, Nierhoff J, et al. Contrast-Enhanced Ultrasound for the differentiation of benign and malignant focal liver lesions: a meta-analysis. Liver International. 2013;33(5):739-55.
39. Ren J, Wu T, Zheng B-W, et al. Application of contrast-enhanced ultrasound after liver transplantation: Current status and perspectives. World Journal of Gastroenterology. 2016;22(4):1607-16.
40. Berstad AE, Brabrand K, Foss A. Clinical utility of microbubble contrast-enhanced ultrasound in the diagnosis of hepatic artery occlusion after liver transplantation. Transplant International Official Journal of the European Society for Organ Transplantation. 2009;22(10):954–60.
41. Berry JD, Sidhu PS. Microbubble contrast-enhanced ultrasound in liver transplantation. European Radiology. 2004;14 Suppl 8(8):P96.
42. Ren J, Zheng R, Yan P. Assessment of Portal Vein System with Contrast-enhanced Ultrasound in the Liver Transplant Candidates. Chinese Journal of Ultrasound in Medicine. 2007; 1:55.
43. Busuttil RW, Farmer DG, Yersiz H, et al. Analysis of Long-term Outcomes of 3200 Liver Transplantations Over Two Decades: A Single-Center Experience. Annals of Surgery. 2005;241(6):905-18.
Related articles

Letter

Calcifying fibrous tumor and pathological analysis

DOI: 10.17235/reed.2023.9739/2023

Letter

Endoscopic observation of a rare duodenal tumor

DOI: 10.17235/reed.2023.9679/2023

Editorial

Recent advances in the diagnosis and management of Wilson’s disease

DOI: 10.17235/reed.2023.9633/2023

Letter

Vaginal lesion as first manifestation of colorectal disease

DOI: 10.17235/reed.2022.9270/2022

Digestive Diseases Image

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Letter

Sigmoid colon Schwannoma simulating colon cancer

DOI: 10.17235/reed.2022.8684/2022

Digestive Diseases Image

Posterior reversible encephalopathy syndrome (PRES) in post liver transplantation

DOI: 10.17235/reed.2022.8694/2022

Letter

Ertapenem neurotoxicity in liver transplantation

DOI: 10.17235/reed.2021.8469/2021

Digestive Diseases Image

Abdominal cocoon sign: an unusual cause of intestinal obstruction

DOI: 10.17235/reed.2021.8057/2021

Letter

POEMS syndrome: an uncommon cause of peritoneal effusion

DOI: 10.17235/reed.2021.8027/2021

Digestive Diseases Image

Percutaneous treatment of a splenorenal shunt with an atrial septal closure device

DOI: 10.17235/reed.2020.7701/2020

Letter

Ischemic gastritis and severe diabetic ketoacidosis

DOI: 10.17235/reed.2020.7655/2020

Review

Physical frailty in liver transplantation

DOI: 10.17235/reed.2020.7448/2020

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Review

New non-invasive biomarkers for colorectal cancer screening

DOI: 10.17235/reed.2020.7233/2020

Letter

Management of hepatic artery aneurysms

DOI: 10.17235/reed.2020.7219/2020

Digestive Diseases Image

Epithelioid hemangioendothelioma: a rare cause of a liver tumor

DOI: 10.17235/reed.2020.7127/2020

Editorial

Reflex testing. A key tool for the elimination of hepatitis C

DOI: 10.17235/reed.2020.7201/2020

Letter

Chilaiditi’s and Ogilvie syndromes

DOI: 10.17235/reed.2020.7036/2020

Letter

Hepatocarcinoma diagnosis. Reflection is required

DOI: 10.17235/reed.2020.6845/2019

Letter to the Editor

Post-transplant lymphoproliferative disease after liver transplantation

DOI: 10.17235/reed.2017.5387/2017

Letter to the Editor

Sternal cutaneous metastasis of hilar cholangiocarcinoma

DOI: 10.17235/reed.2017.4979/2017

Letter to the Editor

Liver metastasis from colorectal cancer 12 years after liver transplantation

DOI: 10.17235/reed.2017.4507/2016

Letter to the Editor

About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4297/2016

Citation tools
Chen S, Wang X, Zhang B, Liu B, Pan H. Meta-analysis of the diagnostic value of contrast-enhanced ultrasound for the detection of vascular complications after liver transplantation. 5818/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1910 visits.
This article has been downloaded 134 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 10/07/2018

Accepted: 23/10/2018

Online First: 20/12/2018

Published: 07/05/2019

Article revision time: 98 days

Article Online First time: 163 days

Article editing time: 301 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology