Learning objectives
To describe the normal imaging findings of the pancreatic transplant anatomy.
To develop knowledge about its different complications.
Background
Diabetes mellitus is a very common pathology in our daily practice and a pancreatic transplant is a specific treatment for some selected type-1 diabetic patients.
The aim of this surgical technique is to provide the patient with sufficient functioning beta cell mass that helps restore the normal blood glucose levels.
Thus,
the long-term complications of insulin-dependent diabetes decrease and this improves the survival rates.
The most common approach is through a whole-organ pancreas transplant,
normally in conjunction with a kidney transplant.
There are three main...
Findings and procedure details
Ultrasound (US):
Initial study for the assessment of the pancreatic graft.
Disadvantages: operator dependent,
anatomic challenges (bowel gas may cause obscuration of the graft).
Gray-scale US: hypoechoic homogeneous soft-tissue structure (Fig.
1).
Doppler US: demonstrates an optimal parenchymal perfusion and vascular anatomy (Fig.2). Nonspecific Spectral Doppler: normal arterial waveforms show a rapid systolic upstroke and continuous diastolic blood flow.
Venous structures have a monophasic waveform (Fig.
3).
CT:
CT is useful when the ultrasound is difficult to be performed. This technique enables to value all...
Conclusion
Currently,
pancreatic transplant is not an unusual treatment for diabetic patients.
Radiologists have to be familiar with the normal postoperative imaging appearances to make an accurate diagnose of the complications.
References
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Manning MA,
Frazier AA,
Wong-You-Cheong JJ.
Imaging of whole-organ pancreas transplants.
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Nikolaidis P,
Amin RS,
Hwang CM,
Mc Carthy RM,
Clark JH,
Gruber SA,
Chen PC.
Role of sonography in pancreatic tansplantation.
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Allan PL,
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Ecografía doppler clínica.
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