Duke University Medical Center, Durham, NC 27710, USA.
Acad Radiol. 2010 Apr;17(4):418-20. doi: 10.1016/j.acra.2010.01.011.
Shunt surveillance is a critical component of follow-up for patients with cirrhosis with transjugular intrahepatic portosystemic shunts (TIPS). Transabdominal Doppler ultrasound analysis of the shunt has been used as a noninvasive means of assessing shunt function. Doppler ultrasound analysis of the shunt is less sensitive than direct transjugular portosystemic pressure gradient measurement for detecting shunt failure. A wireless, noninvasive means of measuring the portosystemic pressure gradient in the clinic may facilitate follow-up in this group of patients. The aim of this study was to determine if two implanted wireless pressure sensors could accurately transmit a portosystemic pressure gradient across a TIPS.
Two wireless microelectromechanical system pressure sensors were placed in a swine model for measuring the portosystemic pressure gradient across a TIPS. Catheter-based pressure transducers were also placed and used as the gold standard. Pressures from both systems were measured concurrently.
Wireless microelectromechanical system portal and systemic pressure measurements were accurate within +/-2 mm Hg (mean, 0.86 mm Hg) of the gold standard.
The use of wireless sensors may facilitate the surveillance of shunt function in patients with portal hypertension who have undergone placement of TIPS.
分流监测是肝硬化伴经颈静脉肝内门体分流术(TIPS)患者随访的关键组成部分。经腹多普勒超声分析分流已被用作评估分流功能的一种非侵入性手段。与直接经颈静脉门体压力梯度测量相比,多普勒超声分析分流的灵敏度较低,无法检测分流失败。在临床中使用无线、非侵入性的方法测量门体压力梯度可能会方便这组患者的随访。本研究的目的是确定两个植入的无线压力传感器是否能够准确地传输 TIPS 上的门体压力梯度。
在猪模型中放置了两个无线微机电系统压力传感器,以测量 TIPS 上的门体压力梯度。还放置了基于导管的压力换能器作为金标准。同时测量两个系统的压力。
无线微机电系统门静脉和体循环压力测量值与金标准相差 +/-2 毫米汞柱(平均值为 0.86 毫米汞柱)以内。
在已接受 TIPS 治疗的门静脉高压患者中,使用无线传感器可能会方便监测分流功能。