Abstract: Objective The aim of this study was to investigate the diagnostic efficacy of multimodal contrast-enhanced ultrasound (CEUS) in diagnosing arterial complications (AC) in recipients of liver transplantation (LT). Methods A cohort of 79 patients with end-stage liver diseases were encountered in our hospital between May 2019 and May 2024, and all patients underwent orthotopic liver transplantation (OLT). After the operation, digital subtraction angiography (DSA) as golden criteria, 2D grey-scale ultrasonography, color Doppler imaging (CDI), spectral Doppler and pulsed wave Doppler imaging, and CEUS were conducted. Receiver operating characteristic curve (ROC) was applied to evaluate diagnostic performance. Results DSA showed normal hepatic arteries in 39 cases (49.4%), and ACs in 40 cases (50.6%)in our 79 recipients of LT, and of which were hepatic artery thrombosis (HAT)in 16 cases, hepatic artery stricture(HAS) in 13 cases, splenic arterial steal syndrome (ASS) in 6 cases and splenic artery aneurysm in 5 cases;there were no significant differences as respect to prevalence of ACs after OLT among patients with underlying liver cirrhosis in 35 cases, liver failure in 20 cases and primary liver cancers in 24 cases (P>0.05); the sensitivity, specificity, accuracy, positive predictive value and negative predictive value by CEUS in finding ACs were 90.0%,97.4%,93.7%,97.3%and 90.5%, while they were 97.5%(P<0.05), 89.7%(P<0.05),93.7%, 90.7% and 97.2% by conventional ultrasonography. Conclusions CEUS check-up for ACs could help clinicians make appropriate measures early and might improve the prognosis of recipients in this setting.

Key words: Liver transplantation, Arterial complications, Multimodal ultrasound, Contrast-enhanced ultrasound, Diagnosis