The purpose of this study was to evaluate the accuracy of multidedector computed tomographic angiography (MDCTA) in detecting hepatic artery complications after orthotopic liver transplantation. Between July 2001 and July 2004, sixteen patients with a clinical suspicion of vascular complication after orthotopic liver transplantation underwent MDCTA for the evaluation of hepatic arteries. MDCTA was performed after intravenous injection of 150 ml of contrast material at a rate of 4 ml/sec. Arterial phase images (0.75 mm collimation, 1 mm slice thickness, table speed of 7.8 mm per gantry rotation) were acquired after contrast injection. Afterwards maximum intensity projections and volume rendered images were produced from axial image data. Digital substraction angiography was performed in the 11 of these patients.
MDCTA was able to depict the celiac axis and the hepatic anostomosis in all patients. A total of 14 hepatic artery complications were identified in 13 patients with MDCTA. Ten patients had hepatic artery stenosis and three patients had hepatic artery thrombosis on the CT angiograms. Eleven of these patients had correlative catheter angiography and catheter angiography confirmed CT angiographic findings. In one patient stenosis at one level was detected with catheter angiograhy whereas MDCTA showed two stenoses falsely. Remaining two patients had clinical follow up. MDCTA is able to rapidly and accurately depict the arterial anatomy after orthotopic liver transplantation allowing accurate detection of arterial stenosis or thrombosis.