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Erschienen in:

30.10.2018

Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation

verfasst von: Hye Jin Kim, Mi-Suk Park, Jin Woo Son, Kyunghwa Han, Jei Hee Lee, Jai Keun Kim, Hyo Chae Paik

Erschienen in: Abdominal Radiology | Ausgabe 4/2019

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Abstract

Purpose

The purpose of this study was to investigate the radiological patterns of secondary sclerosing cholangitis (SSC) following lung transplantation.

Methods

Fifty-five patients underwent abdominopelvic CT before and after lung transplantation for end stage pulmonary disease. Nine patients underwent MR cholangiopancreatography (MRCP). The radiological patterns of biliary abnormalities (location, bile duct dilatation with stricture, beaded appearance, and biliary casts/sludge), laboratory data (serum total bilirubin and alkaline phosphatase), and patient survival rates were evaluated. SSC was diagnosed when there were newly developed biliary abnormalities with cholestasis after lung transplantation. Potential perioperative risk factors pertaining to SSC were analyzed. Patient survival rates with or without SSC were compared.

Results

Six of the 55 patients showed imaging and laboratory findings of SSC after lung transplantation. Multifocal dilatation and stricture involved the intrahepatic (6 of 6, 100%), hilar (4 of 6, 66.7%), and extrahepatic bile duct (1 of 6, 16.7%). On CT, the lesions presented as multifocal small cyst-like lesions along the bile duct course. On MRCP, the lesions showed beaded appearance with mild duct dilatation. Preoperative mechanical ventilation and bilateral lung transplantation were associated with SSC (p < 0.05). The median survival of patients with SSC was 4.6 months.

Conclusion

Lung transplantation can induce SSC similar to SSC in critically ill patients, and result in worse clinical outcomes than in patients without SSC. Multifocal small cyst-like lesions along the intrahepatic bile duct on CT and beaded appearance on MRCP are suggestive findings of SSC in patients with cholestasis after lung transplantation.
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Metadaten
Titel
Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation
verfasst von
Hye Jin Kim
Mi-Suk Park
Jin Woo Son
Kyunghwa Han
Jei Hee Lee
Jai Keun Kim
Hyo Chae Paik
Publikationsdatum
30.10.2018
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 4/2019
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1819-2

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