Abstract:

Objective To investigate the correlation between quantitative contrast-enhanced ultrasound （CEUS） parameters of donor livers and pathological features， and to evaluate their predictive value for early posttransplant complications. Methods Between October 20th，2021， and November 29th，2024，127 liver donors and 89 recipients was enrolled at our center. Potential donors underwent liver CEUS examination before procurement with quantitative parameters analysis，such as wash in slope （WIS）， rise time （RT）， mean transit time （MTT）， and Time from Peak to 1/2（T1/2）. During procurement， donor livers were biopsied and grouped according to the scheuer score to explore the correlation between CEUS parameters and pathological features. Recipient clinical data was collected 6 months posttransplantation to further investigate the relationship between these parameters and early post-transplant complications. Results Prolonged MTT （OR ＝ 1.122，95%CI ＝ 1.008 ～ 1.250，P ＝ 0.036） and shortened T1/2（OR ＝ 0.749，95%CI ＝ 0.584-0.961，P ＝ 0.023） were risk factors for liver inflammation and fibrosis. WIS correlated positively with portal inflammation， hepatocyte hydropic degeneration， and inflammatory activity （P ＜ 0.05）， while negatively correlated

with microvesicular hepatic steatosis （P ＜ 0.05）. Early allograft dysfunction occurred in 24.72% of recipients， with no significant difference in CEUS parameters compared to the normal group. Acute rejection occurred in 10.11%. Compared to the non-rejection group， these recipients were younger （P ＝ 0.004） and had longer MTT （P ＝ 0.036） and RT （P ＝0.039）. The AUC value was 0.776 when combining recipient age， MTT， and RT predicted acute rejection （sensitivity55.6%， specificity 95.0%）. Conclusion CEUS quantitative parameters show significant correlation with donor liver pathological features， demonstrating potential for noninvasive assessment of graft quality and prediction of acute rejectionafter transplantation. 

Key words:

 , Contrast-enhanced ultrasound,  , Quantitative parameters,  , Liver transplantation,  , Pathology,  , Acute , rejection

摘要：

目的 探讨供肝超声造影（contrast-enhanced ultrasound， CEUS）定量参数与病理特征的相关性，并评估其对移植术后早期并发症的预测价值。方法 前瞻性纳入 2021 年 10 月 20 日至 2024 年 11 月29 日华中科技大学同济医学院附属同济医院器官移植中心收治的 127 例肝移植供者及 89 例受者。获取前对潜在供者行肝脏 CEUS 检查，定量分析冲洗斜率（wash in slope， WIS）、上升时间（rise time， RT）、平均通过时间（mean transit time， MTT）、半降时间（time from peak to 1/2，T1/2）等参数。获取时行供肝活检，依据 Scheuer 评分分组，探究 CEUS 参数与病理特征的相关性。收集受者术后 6 个月临床资料，探讨上述参数与移植术后早期并发症的关系。结果 MTT 长（OR ＝ 1.122，95%CI ＝ 1.008 ～ 1.250，P ＝ 0.036）和 T1/2 短（OR ＝ 0.749，95%CI ＝ 0.584 ～ 0.961，P ＝ 0.023）是肝脏炎症及纤维化的危险因素。门管区炎症、肝细胞水性变、炎症活 动度与 WIS 呈正相关，小泡性肝细胞脂肪变与 WIS 呈负相关（P ＜ 0.05）。24.72% 的受者出现早期移植物功能不全，但 CEUS 参数与正常组无显著差异。10.11% 的受者发生急性排斥反应，排斥组受者比正常组年龄更小（P ＝ 0.004），MTT （P ＝ 0.036）和 RT（P ＝ 0.039）更长。受者年龄、MTT 及 RT 联合预测急性排斥反应的 AUC 为 0.776，敏感度、特异度分别为 55.6%、95.0%。结论 CEUS 定量参数与供肝病理特征显著相关，有潜力用于供肝质量无创评估及预测移植术后急性排斥反应。

关键词: 超声造影 , 定量参数 , 肝移植 , 病理 , 急性排斥反应