Microbubble contrast-enhanced ultrasound in the vascular evaluation after pancreas transplantation: a single-center experience

Abstract

Background: Arterial and venous thrombosis are feared complications of pancreas transplantation (PTx). Microbubble contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technique that can augment diagnostic capabilities of transplant organ perfusion.

Purpose: To document the state to which CEUS can improve the vascular evaluation of PTx compared to conventional Doppler ultrasound (US) directly after surgery.

Material and Methods: A total of 129 consecutive PTx in 128 adult patients were eligible for inclusion. The duodenal segment of the graft was anastomosed to the native duodenum. Within 12 h postoperatively, graft- circulation was monitored by Doppler US in 116 PTx performed in 116 patients (69 men, 47 women; mean age 41 years). CEUS was performed with a sulfur hexafluoride-containing contrast agent (SonoVue) intravenously if the examiner was not able to confirm normal graft circulation. Image quality was documented by two independent observers on a 4-point scale: 1 excellent; 2 minor diagnostic limitations; 3 major diagnostic limitations; and 4 non-diagnostic.

Results: In the early postoperative phase, 79 (68%) of 116 PTx were examined with Doppler US only. Of these, 52 were of excellent quality (grade 1), 22 of good quality (grade 2), and five were of grade 3 or 4 quality. Thirty-seven (32%) examinations were supplemented by CEUS. CEUS significantly improved examination quality compared to Doppler US alone (median visualization score 1.5 vs. 2.5, respectively; P < 0.0001).

Conclusion: CEUS can significantly improve vascular evaluation of PTx compared to Doppler US alone in the early postoperative phase.