DOI: 10.1148/rg.264055081
Pediatric Liver Transplantation: A Pictorial Essay of Early and Late Complications1
Teresa Berrocal, MD, PhD,
Manuel Parrón, MD,
Arturo Álvarez-Luque, MD,
Consuelo Prieto, MD and
Manuel López Santamaría, MD, PhD
1 From the Department of Radiology, Division of Pediatric Radiology (T.B., M.P., A.A.L., C.P.) and the Department of Pediatric Surgery (M.L.S.), University Hospital La Paz, Paseo de la Castellana 263, 28046 Madrid, Spain. Recipient of a Magna Cum Laude award for an education exhibit at the 2004 RSNA annual meeting. Received April 6, 2005; revision requested June 29 and received August 22; accepted September 6. All authors have no financial relationships to disclose.
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Figure 1a. Hepatic artery stenosis in a 5-year-old patient. (a) Duplex Doppler US image of the main hepatic artery obtained proximal to an anastomosis shows a normal pattern. (b) Duplex Doppler US image obtained at the anastomosis shows an elevated peak velocity (1.64 m/sec) and spectral broadening, findings that are consistent with turbulence. (c) Duplex Doppler US image of the intrahepatic artery shows a tardus parvus waveform with a decreased resistive index (0.40). (d) Duplex color Doppler US image shows a prolonged acceleration time (120 msec), a finding that is consistent with hepatic artery stenosis. (e) MR angiogram demonstrates a stenosis (arrow) at the anastomosis.
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Figure 1b. Hepatic artery stenosis in a 5-year-old patient. (a) Duplex Doppler US image of the main hepatic artery obtained proximal to an anastomosis shows a normal pattern. (b) Duplex Doppler US image obtained at the anastomosis shows an elevated peak velocity (1.64 m/sec) and spectral broadening, findings that are consistent with turbulence. (c) Duplex Doppler US image of the intrahepatic artery shows a tardus parvus waveform with a decreased resistive index (0.40). (d) Duplex color Doppler US image shows a prolonged acceleration time (120 msec), a finding that is consistent with hepatic artery stenosis. (e) MR angiogram demonstrates a stenosis (arrow) at the anastomosis.
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Figure 1c. Hepatic artery stenosis in a 5-year-old patient. (a) Duplex Doppler US image of the main hepatic artery obtained proximal to an anastomosis shows a normal pattern. (b) Duplex Doppler US image obtained at the anastomosis shows an elevated peak velocity (1.64 m/sec) and spectral broadening, findings that are consistent with turbulence. (c) Duplex Doppler US image of the intrahepatic artery shows a tardus parvus waveform with a decreased resistive index (0.40). (d) Duplex color Doppler US image shows a prolonged acceleration time (120 msec), a finding that is consistent with hepatic artery stenosis. (e) MR angiogram demonstrates a stenosis (arrow) at the anastomosis.
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Figure 1d. Hepatic artery stenosis in a 5-year-old patient. (a) Duplex Doppler US image of the main hepatic artery obtained proximal to an anastomosis shows a normal pattern. (b) Duplex Doppler US image obtained at the anastomosis shows an elevated peak velocity (1.64 m/sec) and spectral broadening, findings that are consistent with turbulence. (c) Duplex Doppler US image of the intrahepatic artery shows a tardus parvus waveform with a decreased resistive index (0.40). (d) Duplex color Doppler US image shows a prolonged acceleration time (120 msec), a finding that is consistent with hepatic artery stenosis. (e) MR angiogram demonstrates a stenosis (arrow) at the anastomosis.
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Figure 1e. Hepatic artery stenosis in a 5-year-old patient. (a) Duplex Doppler US image of the main hepatic artery obtained proximal to an anastomosis shows a normal pattern. (b) Duplex Doppler US image obtained at the anastomosis shows an elevated peak velocity (1.64 m/sec) and spectral broadening, findings that are consistent with turbulence. (c) Duplex Doppler US image of the intrahepatic artery shows a tardus parvus waveform with a decreased resistive index (0.40). (d) Duplex color Doppler US image shows a prolonged acceleration time (120 msec), a finding that is consistent with hepatic artery stenosis. (e) MR angiogram demonstrates a stenosis (arrow) at the anastomosis.
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Figure 2a. Hepatic artery stenosis caused by postsurgical edema at the anastomosis in a 3-year-old patient. (a) Control duplex color US image obtained 24 hours after transplantation shows a tardus parvus waveform. (b) Control duplex color US image obtained 2 days later demonstrates a normal hepatic arterial waveform.
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Figure 2b. Hepatic artery stenosis caused by postsurgical edema at the anastomosis in a 3-year-old patient. (a) Control duplex color US image obtained 24 hours after transplantation shows a tardus parvus waveform. (b) Control duplex color US image obtained 2 days later demonstrates a normal hepatic arterial waveform.
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Figure 3a. Hepatic artery thrombosis in a 22-month-old patient. (a) Transverse color Doppler US image obtained at the porta hepatis shows normal flow in the portal vein and total absence of flow in the hepatic artery. (b) Pulsed color Doppler US image demonstrates total absence of arterial flow at the porta hepatis. P = portal vein. (c) MR angiogram helps confirm complete thrombosis of the hepatic artery (arrow).
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Figure 3b. Hepatic artery thrombosis in a 22-month-old patient. (a) Transverse color Doppler US image obtained at the porta hepatis shows normal flow in the portal vein and total absence of flow in the hepatic artery. (b) Pulsed color Doppler US image demonstrates total absence of arterial flow at the porta hepatis. P = portal vein. (c) MR angiogram helps confirm complete thrombosis of the hepatic artery (arrow).
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Figure 3c. Hepatic artery thrombosis in a 22-month-old patient. (a) Transverse color Doppler US image obtained at the porta hepatis shows normal flow in the portal vein and total absence of flow in the hepatic artery. (b) Pulsed color Doppler US image demonstrates total absence of arterial flow at the porta hepatis. P = portal vein. (c) MR angiogram helps confirm complete thrombosis of the hepatic artery (arrow).
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Figure 4a. Hepatic artery thrombosis in a 2-year-old girl. (a) Control duplex US image obtained 48 hours after transplantation shows a normal hepatic arterial waveform. (b) Control duplex US image obtained 24 hours later demonstrates low systolic and diastolic flow. (c) Control duplex US image obtained 6 hours later shows total absence of arterial flow. (d) Arteriogram helps confirm hepatic artery thrombosis (arrow) at the level of the graft between the donor hepatic artery and the recipient aorta. A balloon was inserted into the graft, and fibrinolytic therapy was administered to preserve the liver. No retransplantation was necessary.
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Figure 4b. Hepatic artery thrombosis in a 2-year-old girl. (a) Control duplex US image obtained 48 hours after transplantation shows a normal hepatic arterial waveform. (b) Control duplex US image obtained 24 hours later demonstrates low systolic and diastolic flow. (c) Control duplex US image obtained 6 hours later shows total absence of arterial flow. (d) Arteriogram helps confirm hepatic artery thrombosis (arrow) at the level of the graft between the donor hepatic artery and the recipient aorta. A balloon was inserted into the graft, and fibrinolytic therapy was administered to preserve the liver. No retransplantation was necessary.
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Figure 4c. Hepatic artery thrombosis in a 2-year-old girl. (a) Control duplex US image obtained 48 hours after transplantation shows a normal hepatic arterial waveform. (b) Control duplex US image obtained 24 hours later demonstrates low systolic and diastolic flow. (c) Control duplex US image obtained 6 hours later shows total absence of arterial flow. (d) Arteriogram helps confirm hepatic artery thrombosis (arrow) at the level of the graft between the donor hepatic artery and the recipient aorta. A balloon was inserted into the graft, and fibrinolytic therapy was administered to preserve the liver. No retransplantation was necessary.
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Figure 4d. Hepatic artery thrombosis in a 2-year-old girl. (a) Control duplex US image obtained 48 hours after transplantation shows a normal hepatic arterial waveform. (b) Control duplex US image obtained 24 hours later demonstrates low systolic and diastolic flow. (c) Control duplex US image obtained 6 hours later shows total absence of arterial flow. (d) Arteriogram helps confirm hepatic artery thrombosis (arrow) at the level of the graft between the donor hepatic artery and the recipient aorta. A balloon was inserted into the graft, and fibrinolytic therapy was administered to preserve the liver. No retransplantation was necessary.
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Figure 5a. Hepatic artery thrombosis in a 7-year-old boy. (a) Duplex color Doppler US image shows absence of arterial flow at the porta hepatis. (b) Duplex US image shows intrahepatic arterial vessels with a tardus parvus pattern due to collateral vessels. (c) MR angiogram helps confirm hepatic artery thrombosis (arrow) at the anastomosis.
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Figure 5b. Hepatic artery thrombosis in a 7-year-old boy. (a) Duplex color Doppler US image shows absence of arterial flow at the porta hepatis. (b) Duplex US image shows intrahepatic arterial vessels with a tardus parvus pattern due to collateral vessels. (c) MR angiogram helps confirm hepatic artery thrombosis (arrow) at the anastomosis.
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Figure 5c. Hepatic artery thrombosis in a 7-year-old boy. (a) Duplex color Doppler US image shows absence of arterial flow at the porta hepatis. (b) Duplex US image shows intrahepatic arterial vessels with a tardus parvus pattern due to collateral vessels. (c) MR angiogram helps confirm hepatic artery thrombosis (arrow) at the anastomosis.
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Figure 6. Portal vein thrombosis in a 12-year-old boy. Color Doppler US image obtained at the porta hepatis shows absence of flow in the portal vein (P). An acute thrombus is anechoic and can be identified only at color flow imaging as a flow defect. Note the normal hepatic artery (AH).
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Figure 7a. Portal vein thrombosis in a 13-year-old girl. (a) On a subcostal oblique color Doppler US image obtained at the porta hepatis, echogenic material is seen in the lumen of the portal vein (P), a finding that represents thrombus. Note the absence of flow in the vessel. AH = hepatic artery. (b) Pulsed duplex Doppler US image obtained at the portal vein demonstrates no flow. (c) MR angiogram shows a filling defect in the portal vein (arrow) caused by thrombus at the confluence of the splenic and superior mesenteric veins. The MPV is completely thrombosed (arrowhead).
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Figure 7b. Portal vein thrombosis in a 13-year-old girl. (a) On a subcostal oblique color Doppler US image obtained at the porta hepatis, echogenic material is seen in the lumen of the portal vein (P), a finding that represents thrombus. Note the absence of flow in the vessel. AH = hepatic artery. (b) Pulsed duplex Doppler US image obtained at the portal vein demonstrates no flow. (c) MR angiogram shows a filling defect in the portal vein (arrow) caused by thrombus at the confluence of the splenic and superior mesenteric veins. The MPV is completely thrombosed (arrowhead).
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Figure 7c. Portal vein thrombosis in a 13-year-old girl. (a) On a subcostal oblique color Doppler US image obtained at the porta hepatis, echogenic material is seen in the lumen of the portal vein (P), a finding that represents thrombus. Note the absence of flow in the vessel. AH = hepatic artery. (b) Pulsed duplex Doppler US image obtained at the portal vein demonstrates no flow. (c) MR angiogram shows a filling defect in the portal vein (arrow) caused by thrombus at the confluence of the splenic and superior mesenteric veins. The MPV is completely thrombosed (arrowhead).
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Figure 8a. (a) Portal cavernoma in an 18-month-old boy. Color Doppler US image obtained at the porta hepatis in a reduced-size transplant shows numerous vascular structures. (b, c) Portal cavernoma in a different patient. (b) Pulsed duplex color Doppler US image demonstrates collateral veins representing cavernous transformation of the portal vein caused by long-standing thrombotic occlusion. (c) MR angiogram shows cavernomatous vessels (arrow) and collateralization of preexisting paragastric varices.
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Figure 8b. (a) Portal cavernoma in an 18-month-old boy. Color Doppler US image obtained at the porta hepatis in a reduced-size transplant shows numerous vascular structures. (b, c) Portal cavernoma in a different patient. (b) Pulsed duplex color Doppler US image demonstrates collateral veins representing cavernous transformation of the portal vein caused by long-standing thrombotic occlusion. (c) MR angiogram shows cavernomatous vessels (arrow) and collateralization of preexisting paragastric varices.
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Figure 8c. (a) Portal cavernoma in an 18-month-old boy. Color Doppler US image obtained at the porta hepatis in a reduced-size transplant shows numerous vascular structures. (b, c) Portal cavernoma in a different patient. (b) Pulsed duplex color Doppler US image demonstrates collateral veins representing cavernous transformation of the portal vein caused by long-standing thrombotic occlusion. (c) MR angiogram shows cavernomatous vessels (arrow) and collateralization of preexisting paragastric varices.
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Figure 9a. Portal vein stenosis in a 5-year-old boy. (a) Longitudinal US image of the MPV shows stenosis (arrow) at the anastomosis between the donor and recipient portal veins. (b, c) Duplex US images show velocities in the stenotic segment (4.55 m/sec) (b) and poststenotic segment (1.27 m/sec) (c) that are more than seven and two times, respectively, greater than the velocity in the prestenotic segment (not shown), which was 0.6 m/sec. These findings are consistent with significant stenosis. (d) MR angiogram reveals portal vein stenosis (arrow) at the anastomosis.
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Figure 9b. Portal vein stenosis in a 5-year-old boy. (a) Longitudinal US image of the MPV shows stenosis (arrow) at the anastomosis between the donor and recipient portal veins. (b, c) Duplex US images show velocities in the stenotic segment (4.55 m/sec) (b) and poststenotic segment (1.27 m/sec) (c) that are more than seven and two times, respectively, greater than the velocity in the prestenotic segment (not shown), which was 0.6 m/sec. These findings are consistent with significant stenosis. (d) MR angiogram reveals portal vein stenosis (arrow) at the anastomosis.
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Figure 9c. Portal vein stenosis in a 5-year-old boy. (a) Longitudinal US image of the MPV shows stenosis (arrow) at the anastomosis between the donor and recipient portal veins. (b, c) Duplex US images show velocities in the stenotic segment (4.55 m/sec) (b) and poststenotic segment (1.27 m/sec) (c) that are more than seven and two times, respectively, greater than the velocity in the prestenotic segment (not shown), which was 0.6 m/sec. These findings are consistent with significant stenosis. (d) MR angiogram reveals portal vein stenosis (arrow) at the anastomosis.
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Figure 9d. Portal vein stenosis in a 5-year-old boy. (a) Longitudinal US image of the MPV shows stenosis (arrow) at the anastomosis between the donor and recipient portal veins. (b, c) Duplex US images show velocities in the stenotic segment (4.55 m/sec) (b) and poststenotic segment (1.27 m/sec) (c) that are more than seven and two times, respectively, greater than the velocity in the prestenotic segment (not shown), which was 0.6 m/sec. These findings are consistent with significant stenosis. (d) MR angiogram reveals portal vein stenosis (arrow) at the anastomosis.
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Figure 10a. Portal vein stenosis in a 13-month-old girl. (a) Longitudinal US image of the MPV shows stenosis of an entire vascular graft (arrows) that was used to anastomose the vein. (b) Duplex US image of the poststenotic area shows a high flow velocity (1.1 m/sec).
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Figure 10b. Portal vein stenosis in a 13-month-old girl. (a) Longitudinal US image of the MPV shows stenosis of an entire vascular graft (arrows) that was used to anastomose the vein. (b) Duplex US image of the poststenotic area shows a high flow velocity (1.1 m/sec).
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Figure 11a. (a) IVC thrombosis in a 6-year-old boy. Longitudinal color Doppler US image obtained through the hepatic vein confluence (arrow) shows absence of flow in the preanastomotic IVC. (b) IVC thrombosis in a different patient. Longitudinal color Doppler US image obtained through the retrohepatic vena cava shows an echogenic thrombus (arrows) filling the lumen of the IVC.
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Figure 11b. (a) IVC thrombosis in a 6-year-old boy. Longitudinal color Doppler US image obtained through the hepatic vein confluence (arrow) shows absence of flow in the preanastomotic IVC. (b) IVC thrombosis in a different patient. Longitudinal color Doppler US image obtained through the retrohepatic vena cava shows an echogenic thrombus (arrows) filling the lumen of the IVC.
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Figure 12a. IVC stenosis in a 14-year-old boy. (a) Longitudinal US image shows focal narrowing of the IVC lumen. (b, c) Duplex Doppler US images show that the flow velocity in the poststenotic segment of the IVC (c) is nearly four times greater than that in the prestenotic segment (b).
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Figure 12b. IVC stenosis in a 14-year-old boy. (a) Longitudinal US image shows focal narrowing of the IVC lumen. (b, c) Duplex Doppler US images show that the flow velocity in the poststenotic segment of the IVC (c) is nearly four times greater than that in the prestenotic segment (b).
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Figure 12c. IVC stenosis in a 14-year-old boy. (a) Longitudinal US image shows focal narrowing of the IVC lumen. (b, c) Duplex Doppler US images show that the flow velocity in the poststenotic segment of the IVC (c) is nearly four times greater than that in the prestenotic segment (b).
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Figure 13a. Budd-Chiari syndrome in a 9-year-old boy who had undergone whole liver transplantation. (a) Sagittal oblique duplex US image shows a monophasic wave pattern of the hepatic vein. (b) Duplex color Doppler US image shows biphasic hepatofugal flow in the portal vein.
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Figure 13b. Budd-Chiari syndrome in a 9-year-old boy who had undergone whole liver transplantation. (a) Sagittal oblique duplex US image shows a monophasic wave pattern of the hepatic vein. (b) Duplex color Doppler US image shows biphasic hepatofugal flow in the portal vein.
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Figure 14a. IVC stenosis in a 4-year-old patient with a left caval vein. (a) MR angiogram shows stenosis (arrow) in the superior IVC anastomosis. (b) Angiogram also demonstrates the stenosis (arrow), which was treated with endovascular balloon dilation.
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Figure 14b. IVC stenosis in a 4-year-old patient with a left caval vein. (a) MR angiogram shows stenosis (arrow) in the superior IVC anastomosis. (b) Angiogram also demonstrates the stenosis (arrow), which was treated with endovascular balloon dilation.
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Figure 15a. (a, b) Biliary dilatation in a 4-year-old girl with severe hepatic artery stenosis who had undergone reduced-size liver transplantation. (a) Transverse US image shows segmental dilatation of the biliary tree. (b) Duplex Doppler US image of the hepatic artery shows a tardus parvus waveform with low systolic and diastolic velocities, a low resistive index, and a prolonged acceleration time, findings that are consistent with stenosis. (c) Biliary dilatation in a different patient who had undergone whole liver transplantation. MR cholangiogram shows postsurgical biliary stenosis (arrow) with dilatation from the anastomosis with an intestinal loop. A stent was placed at the stenosis.
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Figure 15b. (a, b) Biliary dilatation in a 4-year-old girl with severe hepatic artery stenosis who had undergone reduced-size liver transplantation. (a) Transverse US image shows segmental dilatation of the biliary tree. (b) Duplex Doppler US image of the hepatic artery shows a tardus parvus waveform with low systolic and diastolic velocities, a low resistive index, and a prolonged acceleration time, findings that are consistent with stenosis. (c) Biliary dilatation in a different patient who had undergone whole liver transplantation. MR cholangiogram shows postsurgical biliary stenosis (arrow) with dilatation from the anastomosis with an intestinal loop. A stent was placed at the stenosis.
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Figure 15c. (a, b) Biliary dilatation in a 4-year-old girl with severe hepatic artery stenosis who had undergone reduced-size liver transplantation. (a) Transverse US image shows segmental dilatation of the biliary tree. (b) Duplex Doppler US image of the hepatic artery shows a tardus parvus waveform with low systolic and diastolic velocities, a low resistive index, and a prolonged acceleration time, findings that are consistent with stenosis. (c) Biliary dilatation in a different patient who had undergone whole liver transplantation. MR cholangiogram shows postsurgical biliary stenosis (arrow) with dilatation from the anastomosis with an intestinal loop. A stent was placed at the stenosis.
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Figure 16a. Bile leaks. (a) US image obtained in an 8-year-old boy shows a large infrahepatic fluid collection (cursors), a finding that represents an extensive biloma. (b) US image obtained in a different patient shows a septated fluid collection (cursors) at the right iliac fossa.
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Figure 16b. Bile leaks. (a) US image obtained in an 8-year-old boy shows a large infrahepatic fluid collection (cursors), a finding that represents an extensive biloma. (b) US image obtained in a different patient shows a septated fluid collection (cursors) at the right iliac fossa.
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Figure 17a. (a) Biliary stones in a 15-year-old boy who had undergone liver transplantation 8 years earlier. Longitudinal US image obtained at the porta hepatis shows a distended CBD and two rounded echogenic calculi (arrows and cursors). (b) Biliary stones in a different patient. Cholangiogram shows multiple filling defects (arrows) within the biliary tree, findings that represent biliary stones.
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Figure 17b. (a) Biliary stones in a 15-year-old boy who had undergone liver transplantation 8 years earlier. Longitudinal US image obtained at the porta hepatis shows a distended CBD and two rounded echogenic calculi (arrows and cursors). (b) Biliary stones in a different patient. Cholangiogram shows multiple filling defects (arrows) within the biliary tree, findings that represent biliary stones.
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Figure 18. Mucocele in an asymptomatic 11-year-old patient who had undergone whole liver transplantation. Transverse color Doppler US image obtained at the porta hepatis shows a large, rounded fluid collection (arrow), a finding that corresponds to dilatation of the bile duct remnant.
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Figure 19a. (a) Hepatic infarct in a 22-month-old patient who had undergone liver transplantation 2 weeks earlier. Transverse US image of the liver shows focal areas of heterogeneous parenchyma (arrows and cursors). These lesions contain central hypoechoic areas that represent necrosis. (b) Hepatic bilomas following hepatic artery thrombosis in a 12-year-old boy who had undergone living related donor liver transplantation for biliary atresia 24 days earlier. US image shows irregular anechoic areas (arrows and cursors) in the transplanted liver.
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Figure 19b. (a) Hepatic infarct in a 22-month-old patient who had undergone liver transplantation 2 weeks earlier. Transverse US image of the liver shows focal areas of heterogeneous parenchyma (arrows and cursors). These lesions contain central hypoechoic areas that represent necrosis. (b) Hepatic bilomas following hepatic artery thrombosis in a 12-year-old boy who had undergone living related donor liver transplantation for biliary atresia 24 days earlier. US image shows irregular anechoic areas (arrows and cursors) in the transplanted liver.
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Figure 20a. Hematoma in the parenchymal resection site of the graft in a 2-year-old girl. (a) Transverse US image obtained 2 days after partial liver transplantation demonstrates a fluid collection (H). (b) Contrast-enhanced CT scan demonstrates a low-attenuation fluid collection (arrows). (c) US image obtained 10 days later shows regression of the hematoma (arrows). C = spine, R = kidney.
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Figure 20b. Hematoma in the parenchymal resection site of the graft in a 2-year-old girl. (a) Transverse US image obtained 2 days after partial liver transplantation demonstrates a fluid collection (H). (b) Contrast-enhanced CT scan demonstrates a low-attenuation fluid collection (arrows). (c) US image obtained 10 days later shows regression of the hematoma (arrows). C = spine, R = kidney.
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Figure 20c. Hematoma in the parenchymal resection site of the graft in a 2-year-old girl. (a) Transverse US image obtained 2 days after partial liver transplantation demonstrates a fluid collection (H). (b) Contrast-enhanced CT scan demonstrates a low-attenuation fluid collection (arrows). (c) US image obtained 10 days later shows regression of the hematoma (arrows). C = spine, R = kidney.
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Figure 21a. Abscess in the parenchymal resection site of the graft in a 4-year-old girl. (a) US image obtained 1 week after reduced-size liver transplantation shows a homogeneous fluid collection (cursors) that represents a hematoma. One month later, the patient developed a fever. (b) US image shows a heterogeneous, encapsulated fluid collection (arrowheads) containing gas (arrows). (c) CT scan obtained during percutaneous drainage helps confirm that the collection is an abscess. Arrow indicates the needle used for drainage.
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Figure 21b. Abscess in the parenchymal resection site of the graft in a 4-year-old girl. (a) US image obtained 1 week after reduced-size liver transplantation shows a homogeneous fluid collection (cursors) that represents a hematoma. One month later, the patient developed a fever. (b) US image shows a heterogeneous, encapsulated fluid collection (arrowheads) containing gas (arrows). (c) CT scan obtained during percutaneous drainage helps confirm that the collection is an abscess. Arrow indicates the needle used for drainage.
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Figure 21c. Abscess in the parenchymal resection site of the graft in a 4-year-old girl. (a) US image obtained 1 week after reduced-size liver transplantation shows a homogeneous fluid collection (cursors) that represents a hematoma. One month later, the patient developed a fever. (b) US image shows a heterogeneous, encapsulated fluid collection (arrowheads) containing gas (arrows). (c) CT scan obtained during percutaneous drainage helps confirm that the collection is an abscess. Arrow indicates the needle used for drainage.
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Figure 22a. PTLD in a 12-year-old patient with Burkitt lymphoma who had undergone liver transplantation 4 years earlier. (a) US image shows solid hepatic nodules and enlarged retroperitoneal lymph nodes (arrows). A = aorta, VC = inferior vena cava. (b) US image shows concentric thickening of a bowel loop. Arrow indicates the bowel lumen. V = bladder. (c) Contrast-enhanced lung CT scan shows a solid nodule (arrow) in the left lung.
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Figure 22b. PTLD in a 12-year-old patient with Burkitt lymphoma who had undergone liver transplantation 4 years earlier. (a) US image shows solid hepatic nodules and enlarged retroperitoneal lymph nodes (arrows). A = aorta, VC = inferior vena cava. (b) US image shows concentric thickening of a bowel loop. Arrow indicates the bowel lumen. V = bladder. (c) Contrast-enhanced lung CT scan shows a solid nodule (arrow) in the left lung.
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Figure 22c. PTLD in a 12-year-old patient with Burkitt lymphoma who had undergone liver transplantation 4 years earlier. (a) US image shows solid hepatic nodules and enlarged retroperitoneal lymph nodes (arrows). A = aorta, VC = inferior vena cava. (b) US image shows concentric thickening of a bowel loop. Arrow indicates the bowel lumen. V = bladder. (c) Contrast-enhanced lung CT scan shows a solid nodule (arrow) in the left lung.
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Figure 23a. (a) Non-Hodgkin lymphoma in a 9-year-old girl. Contrast-enhanced CT scan shows an intraperitoneal solid mass containing prominent enhanced vessels (arrow). Note also the enhancement of the small bowel wall (arrowheads). (b) Non-Hodgkin lymphoma in a different patient who had undergone liver transplantation 7 years earlier. Contrast-enhanced CT scan shows a solid mass in the right hepatic lobe.
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Figure 23b. (a) Non-Hodgkin lymphoma in a 9-year-old girl. Contrast-enhanced CT scan shows an intraperitoneal solid mass containing prominent enhanced vessels (arrow). Note also the enhancement of the small bowel wall (arrowheads). (b) Non-Hodgkin lymphoma in a different patient who had undergone liver transplantation 7 years earlier. Contrast-enhanced CT scan shows a solid mass in the right hepatic lobe.
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Copyright © 2006 by the Radiological Society of North America.
