Ji Young Choi, Kyoung Won Kim, Jong Keon Jang, Sang Hyun Choi, Heon-Ju Kwon, Young-In Yoon, Gi-Won Song, Sung-Gyu Lee
{"title":"多普勒超声在预测肝移植术后急性细胞排斥反应患者临床转归中的价值。","authors":"Ji Young Choi, Kyoung Won Kim, Jong Keon Jang, Sang Hyun Choi, Heon-Ju Kwon, Young-In Yoon, Gi-Won Song, Sung-Gyu Lee","doi":"10.14366/usg.23112","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the value of Doppler ultrasonography in predicting clinical outcomes after antirejection treatment for patients with acute cellular rejection (ACR) following liver transplantation (LT).</p><p><strong>Methods: </strong>This retrospective study included 84 patients who were pathologically diagnosed with ACR and received antirejection treatment within 90 days following LT. Two radiologists searched for abnormal Doppler parameters at ACR diagnosis and within 7 days after antirejection treatment initiation, including portal blood velocity (PBV) <20 cm/s, hepatic artery resistive index <0.5, and a monophasic hepatic vein flow pattern. Interval PBV changes were also evaluated. The frequencies of abnormal Doppler parameters and PBV changes were compared by treatment outcome.</p><p><strong>Results: </strong>The frequency of abnormal PBV in the early post-treatment phase (PBVearly post-treatment) was significantly higher among poor responders (50.0% [10/20]) than among good responders (7.8% [5/64]) (P<0.001). The sensitivity, specificity, and accuracy of abnormal PBVearly post-treatment as a predictor of poor response to antirejection treatment were 50.0% (10/20), 92.2% (59/64), and 82.1% (69/84), respectively. A decrease (>10%) from the PBV at event (PBVevent) to PBVearly post-treatment was significantly more common among poor responders (50.0% [10/20]) than among good responders (20.3% [13/64]) (P=0.019). The sensitivity, specificity, and accuracy of this PBV decrease in predicting poor treatment response were 50.0% (10/20), 79.7% (51/64), and 72.6% (61/84), respectively.</p><p><strong>Conclusion: </strong>Abnormal PBVearly post-treatment and a decrease between PBVevent and PBVearly post-treatment were significantly associated with poor treatment response in patients with ACR after LT. Consequently, Doppler ultrasonography may be useful for predicting clinical outcomes in these patients.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":" ","pages":"572-579"},"PeriodicalIF":2.4000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/67/usg-23112.PMC10555689.pdf","citationCount":"0","resultStr":"{\"title\":\"Value of Doppler ultrasonography in predicting clinical outcomes for patients with acute cellular rejection after liver transplantation.\",\"authors\":\"Ji Young Choi, Kyoung Won Kim, Jong Keon Jang, Sang Hyun Choi, Heon-Ju Kwon, Young-In Yoon, Gi-Won Song, Sung-Gyu Lee\",\"doi\":\"10.14366/usg.23112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study investigated the value of Doppler ultrasonography in predicting clinical outcomes after antirejection treatment for patients with acute cellular rejection (ACR) following liver transplantation (LT).</p><p><strong>Methods: </strong>This retrospective study included 84 patients who were pathologically diagnosed with ACR and received antirejection treatment within 90 days following LT. Two radiologists searched for abnormal Doppler parameters at ACR diagnosis and within 7 days after antirejection treatment initiation, including portal blood velocity (PBV) <20 cm/s, hepatic artery resistive index <0.5, and a monophasic hepatic vein flow pattern. Interval PBV changes were also evaluated. The frequencies of abnormal Doppler parameters and PBV changes were compared by treatment outcome.</p><p><strong>Results: </strong>The frequency of abnormal PBV in the early post-treatment phase (PBVearly post-treatment) was significantly higher among poor responders (50.0% [10/20]) than among good responders (7.8% [5/64]) (P<0.001). The sensitivity, specificity, and accuracy of abnormal PBVearly post-treatment as a predictor of poor response to antirejection treatment were 50.0% (10/20), 92.2% (59/64), and 82.1% (69/84), respectively. A decrease (>10%) from the PBV at event (PBVevent) to PBVearly post-treatment was significantly more common among poor responders (50.0% [10/20]) than among good responders (20.3% [13/64]) (P=0.019). The sensitivity, specificity, and accuracy of this PBV decrease in predicting poor treatment response were 50.0% (10/20), 79.7% (51/64), and 72.6% (61/84), respectively.</p><p><strong>Conclusion: </strong>Abnormal PBVearly post-treatment and a decrease between PBVevent and PBVearly post-treatment were significantly associated with poor treatment response in patients with ACR after LT. 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Value of Doppler ultrasonography in predicting clinical outcomes for patients with acute cellular rejection after liver transplantation.
Purpose: This study investigated the value of Doppler ultrasonography in predicting clinical outcomes after antirejection treatment for patients with acute cellular rejection (ACR) following liver transplantation (LT).
Methods: This retrospective study included 84 patients who were pathologically diagnosed with ACR and received antirejection treatment within 90 days following LT. Two radiologists searched for abnormal Doppler parameters at ACR diagnosis and within 7 days after antirejection treatment initiation, including portal blood velocity (PBV) <20 cm/s, hepatic artery resistive index <0.5, and a monophasic hepatic vein flow pattern. Interval PBV changes were also evaluated. The frequencies of abnormal Doppler parameters and PBV changes were compared by treatment outcome.
Results: The frequency of abnormal PBV in the early post-treatment phase (PBVearly post-treatment) was significantly higher among poor responders (50.0% [10/20]) than among good responders (7.8% [5/64]) (P<0.001). The sensitivity, specificity, and accuracy of abnormal PBVearly post-treatment as a predictor of poor response to antirejection treatment were 50.0% (10/20), 92.2% (59/64), and 82.1% (69/84), respectively. A decrease (>10%) from the PBV at event (PBVevent) to PBVearly post-treatment was significantly more common among poor responders (50.0% [10/20]) than among good responders (20.3% [13/64]) (P=0.019). The sensitivity, specificity, and accuracy of this PBV decrease in predicting poor treatment response were 50.0% (10/20), 79.7% (51/64), and 72.6% (61/84), respectively.
Conclusion: Abnormal PBVearly post-treatment and a decrease between PBVevent and PBVearly post-treatment were significantly associated with poor treatment response in patients with ACR after LT. Consequently, Doppler ultrasonography may be useful for predicting clinical outcomes in these patients.
UltrasonographyMedicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.10
自引率
6.50%
发文量
78
审稿时长
15 weeks
期刊介绍:
Ultrasonography, the official English-language journal of the Korean Society of Ultrasound in Medicine (KSUM), is an international peer-reviewed academic journal dedicated to practice, research, technology, and education dealing with medical ultrasound. It is renamed from the Journal of Korean Society of Ultrasound in Medicine in January 2014, and published four times per year: January 1, April 1, July 1, and October 1. Original articles, technical notes, topical reviews, perspectives, pictorial essays, and timely editorial materials are published in Ultrasonography covering state-of-the-art content.
Ultrasonography aims to provide updated information on new diagnostic concepts and technical developments, including experimental animal studies using new equipment in addition to well-designed reviews of contemporary issues in patient care. Along with running KSUM Open, the annual international congress of KSUM, Ultrasonography also serves as a medium for cooperation among physicians and specialists from around the world who are focusing on various ultrasound technology and disease problems and relevant basic science.