Abstract: Objective To evaluate the clinical application of real-time ultrasound elastography in the evaluation of ischemic biliary lesions （IBL） in patients with orthotopic liver transplantation （OLT）. Methods 52 patients received OLT in our hospital between January 2013 and January 2017, and all of them were checked-up by ultrasonography and real-time ultrasound elasticity imaging to measure portal vein diameter （PVD）,hepatic artery resistance index （HARI）,portal vein velocity （PVV）,hepatic artery pulsatility index （HAPI）,hepatic artery peak systolic velocity （HAV） and shear wave velocity （SWV）. Results There were 10 patients （19.2%） out of the 52 recipients having IBL at 6th month check-up postoperatively;there were no significant differences as respect to PVV,HAV,HARI and HAPI in the two groups（P>0.05）,while the PVD in patients with IBL was higher than that in those without [（1.1±0.2） cm/s vs. （0.8±0.3） cm/s,P<0.05];there was no significant difference in serum AST level between the two groups （P>0.05）,while serum ALP and GGT levels in patients with IBL were much higher than those in the control group （P<0.05）;the SWVs in patients with IBL detected at 4 cm and 5 cm depth were much higher than those in the control group （P<0.05）. Conclusion The real-time ultrasonic elastography is an economical, convenient,noninvasive and repeatable approach for the evaluation of IBL in patients after OLT, which might be of great importance in monitoring the biliary lesions.

Key words: Orthotopic liver transplantation, Ischemic biliary lesions, Real-time ultrasound elastography, Diagnosis