Radiology Studies

There are several studies that we tend to get fairly routinely on our patients.

Ultrasound: When we order an ultrasound on a liver transplant patient, we are usually interested in the anatomy of the graft and blood flow to the graft. We usually obtain limited ultrasound of the liver with doppler studies of the vessels. This allows us to make sure that none of the vessels have become occluded. We also use ultrasound as a baseline for evaluation of the biliary system. If the bile ducts are dilated on the study then we investigate further.

CT: We often get full body CT scans on our patients if we are worried about the possibility of PTLD. We are looking for evidence of mediastinal or retro-peritoneal adenopathy as well as possible solid organ tumor. These studies can usually be done without PO contrast. Discuss it will the radiologist and if they think it can be done without contrast that is fine. IV contrast is usually needed.

MR Cholangiogram: If we suspect that they child may have a biliary stricture, the first step in evaluation is usually, but not always, an MR cholangiogram. This study allows us to do a non-invasive evaluation of the biliary system. It is sometimes difficult to schedule. It usually requires sedation and sometimes the patient needs to be totally anesthetized. Age is usually the factor. Discuss this with the radiologist.

Trans-hepatic Cholangiograms: These studies are done at Christiana Hospital. The scheduling and transportation are usually handled by our nurse practitioners and social worker. The patient needs to have a recent PT/PTT and CBC prior to going for the test. They need to be NPO and sometimes require anesthesia. They may return from the study with a biliary stent.