[Hepatic postinterventional imaging : Modality selection, assessment of therapeutic response, recognition, and
Antonia Dalmer1, Hanka Arndt2, Lennart Well3
1Institut und Poliklinik für Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland. antonia.dalmer@med.uni-rostock.de.
Background:
Postprocedural imaging following hepatic interventions is essential for monitoring treatment success and detecting complications.
Objective:
To provide an overview of imaging follow-up after hepatic interventions (transjugular intrahepatic portosystemic shunt [TIPS], percutaneous transhepatic cholangiography and drainage [PTCD], transarterial chemoembolization [TACE], ablation, selective internal radiotherapy [SIRT]), focusing on the selection of imaging modalities, the assessment of treatment success, and the recognition and radiological management of complications.
Materials And Methods:
Narrative review based on the current literature of hepatic radiological interventions.
Results:
The procedure determines the choice of imaging modality. Following TIPS, functional monitoring is primarily performed using duplex ultrasound. PTCD follow-up focuses on drainage placement and bleeding complications. Following TACE and ablation, immediate hypoperfusion of the lesions is to be expected, whereas a temporary increase in size and peripheral enhancement may occur. Following SIRT, a delayed onset of the treatment effect, as detectable by imaging morphology, is characteristic. Bleeding, abscess formation, fistulas, stent occlusions or malfunctions, and tumor recurrences can be treated further using interventional radiology.
Conclusion:
Knowledge of typical postprocedural imaging findings, as well as common complications and options for radiological treatment of complications, is crucial.
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