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B-Flow Sonography for Detecting Portal Venous Stenosis After Liver Transplantation

Institute of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany, Dirk.Clevert{at}med.uni-muenchen.de

M. Stickel, MD

Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

H. J. Michaely, MD

Institute of Clinical Radiology, University of Munich-xGrosshadern Campus, Munich, Germany

F. Loehe, MD

Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

C. Graeb, MD

Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

H. O. Steitz, MD

Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

T. Strautz

Institute of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany

P. Flach

Institute of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany

S. O. Schoenberg, MD

Institute of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany

K. W. Jauch, MD

Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

M. F. Reiser, MD

Institute of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany

A case of a patient in his early 60s with a portal vein stenosis after liver transplantation (LTx) detected by sonography in B-flow mode is reported. Two weeks after LTx, the patient developed ascites and severe alteration of liver function tests. Color Doppler (CD) demonstrated a stenosis in the portal vein with a maximum flow of 340 cm/sec. Due to aliasing, correct assessment of stenosis diameter was not possible by means of CD. However, by using the B-flow imaging technique, slow and fast velocities in the pre-, intra-, and poststenotic segment could be detected without aliasing or overwriting. In addition, a second stenosis in the portal vein was identified. For the follow-up outcome of patients, it is essential to detect and treat this complication. After surgical intervention, graft function recovered and postoperative flow measurements showed a normal portal vein flow of 70 cm/sec in the poststenotic segment.

Key Words: portal vein stenosis • sonography • liver transplantation • color Doppler • stenosis

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