Usefulness of 16 MDCT with vr (volium rendering) and mip (maximum intensityprojection) reconstruction as a monitoring of pancreatic graft vessels potency during early postoperative period
L Grabowska-Derlatka, T Grochowiecki, R Pacho, T Jakimowicz, O Rowiński
Ann Transplant 2009; 14(1): 23-23
Background: Thrombosis of graft's vessels is the most common complication
after pancreas transplantation. It leads to removal of even 10% of grafts during
the early postoperative period. The aim of this study was to evaluate the usefulness of 16-MDCT with VR (volume rendering) and MIP (maximum intensity projection) reconstruction as a monitoring of pancreatic graft vessels potency during early postoperative period.
Material/Methods: In 40 recipients 16-MDCT was performed including arterial and portal venous phases within 6-8 days after SPKTx. Secondary reconstructions were obtained with the application of VR and MIP algorithm. We evaluated vessels' anastomosis, extra and intrapancreatic arteries and venous morphology, especially diagnosing or excluding graft vessels' thrombosis with MIP reconstruction.
Results: In 17 patients the thrombosis of big pancreatic graft vessels was recognized: in 12 of them thrombosis occurred in big pancreatic veins and arteries and in 5 only in arteries. In addition in 10 out of 17 small clots (2-4mm) in intrapancreatic vessels were observed. In 3 patients only small vessels without big vessels' thrombosis was recognized. All patients with thromboses underwent intravenous heparin treatment.
Conclusions: 16-MDCT with secondary reconstruction with the application VR and MIP algorithm is an efficient method of estimating arterial and venous extra and intrapancreatic vessels. MIP reconstruction allows avoiding false positive recognition of thrombosis especially in parts of vessels' bifurcation. In cases of thrombosis of small intrapancreatic vessels, it allows to detect the early changes and start the treatment without the necessity of graft removal.
Keywords: Pancreas Transplantation