High resolution flow with glazing flow for optimized flow detection in transjugular intrahepatic portosystemic stent shunt (TIPS): First results

Author:

Jung Ernst-Michael1,Jung Friedrich2,Verloh Niklas3,Haimerl Michael1,Lürken Lukas1,Jage Simon1,Stroszczynski Christian1,Scharf Gregor1

Affiliation:

1. Department of Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany

2. Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany

3. Department of Radiology, University Hospital Freiburg, Freiburg, Germany

Abstract

BACKGROUND: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft. OBJECTIVE: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS. METHODS: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts). In all cases, an experienced examiner performed the examinations with a 1–6 MHz probe (Resona 7, Mindray). RESULTS: 61 ultrasound examinations in 48 patients were performed; the mean patient age was 54±14.2 years. The use of HR-Flow with Glazing Flow resulted in an improved flow display in 55/61 cases (90.2%). Both methods correlated well (r = 0.71), but HR flow with Glazing flow values were in general higher than CCDS values. The reading resulted in an average value of 2.52±0.54 for CCDS and 3.52±0.57 for HR flow with Glazing flow (p = 0.013). CONCLUSION: The combination of HR-Flow and Glazing Flow results in improved flow representation and reduction of artifacts in the ultrasound follow-up of TIPS.

Publisher

IOS Press

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Hematology,Physiology

Reference13 articles.

1. Evaluation and management of transjugular intrahepatic portosystemic shunts;Darcy;AJR American Journal of Roentgenology,2012

2. Optimizing Doppler and color flow US: Application to hepatic sonography;Kruskal;Radiographics: A Review Publication of the Radiological Society of North America, Inc,2004

3. Transjugular intrahepatic portosystemic shunt: Indications, contraindications, and patient work-up;Copelan;Seminars in Interventional Radiology,2014

4. Transjugulärer intrahepatischer portosystemischer Stentshunt (TIPS): Pathophysiologische Grundlagen, gegenwärtige Indikationen und Ergebnisse mit Review der Literatur;Strunk;RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin,2018

5. Percutaneous transjugular direct porto-caval shunt in patients with Budd-Chiari syndrome;Quateen;Cardiovascular and Interventional Radiology,2006

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