Detecting biliary complications following liver transplantation with contrast-enhanced ultrasound

Figure 5 A 30-year-old male patient, more than 4 months post-liver transplantation, presented with a one-week history of fever and diarrhea, followed by vomiting and impaired consciousness for two hours. A: Two-dimensional ultrasound showed multiple hypoechoic areas within the transplanted liver, suggestive of infarct foci; B: Color Doppler ultrasound showed that no arterial blood flow signals were observed in the hepatic artery course area, indicating hepatic artery occlusion; C: Intravenous contrast-enhanced ultrasound (CEUS) showed no visualization of the entire hepatic artery, consistent with hepatic artery occlusion; D: Intravenous CEUS indicated no enhancement in multiple hypoechoic areas within the liver, consistent with infarct foci; E: Magnetic resonance imaging revealed multiple hypoattenuating lesions within the liver, with an increase in number and size compared to previous scans, suggesting biloma and intrahepatic biliary duct dilation.