Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.
Department of Oncological and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.
Can J Gastroenterol Hepatol. 2022 Dec 8;2022:7476477. doi: 10.1155/2022/7476477. eCollection 2022.
Transjugular intrahepatic portosystemic shunt (TIPS) alters the liver blood supply and reduces portal pressure. This study was to investigate the changes and associations of the hepatic blood flow, liver volume, and portal pressure gradient (PPG) after TIPS in liver cirrhosis.
Twenty-one patients with liver cirrhosis who received TIPS were recruited. The contrast CT images were used to assess the iodine density (ID) of liver parenchymal and liver volume. The ID of the liver parenchyma was used to reflect hepatic blood flow. We used a paired -test and regression analysis to investigate the effect of TIPS on hepatic blood flow, liver volume, and PPG in individuals with cirrhosis and the factors that affect changes in liver volume.
After TIPS, there was a significant improvement in the ID of liver parenchyma at arterial phase (AP) and PPG in individuals with cirrhosis ( < 0.05). Each 1 unit increase in the ID change of whole liver parenchyma at the venous phase (VP) was significantly associated with a 269.44 cm increase in the liver volume after TIPS ( = 269.44, = 0.012). With an increasing ID change of whole liver parenchyma at VP, the change in liver volume followed an increasing trend ( for overall association = 0.005).
Our data indicate that there was a significant improvement in hepatic blood flow, especially at AP, after TIPS and the change in hepatic blood supply from the portal vein is positively associated with the change in liver volume after TIPS. Increasing the blood supply to the liver from the portal vein may improve the reduction of liver volume.
经颈静脉肝内门体分流术（TIPS）改变肝脏血液供应并降低门静脉压力。本研究旨在探讨 TIPS 后肝硬化患者肝血流、肝体积和门静脉压力梯度（PPG）的变化及其相关性。
招募 21 例接受 TIPS 的肝硬化患者。使用对比 CT 图像评估肝实质和肝体积的碘密度（ID）。肝实质的 ID 用于反映肝血流。我们使用配对检验和回归分析来研究 TIPS 对肝硬化个体肝血流、肝体积和 PPG 的影响，以及影响肝体积变化的因素。
TIPS 后，肝硬化个体肝实质动脉期（AP）ID 和 PPG 均有显著改善（<0.05）。静脉期（VP）整个肝实质 ID 变化增加 1 个单位，与 TIPS 后肝体积增加 269.44cm 显著相关（=269.44，=0.012）。随着 VP 中整个肝实质 ID 变化的增加，肝体积的变化呈现出增加的趋势（整体相关性=0.005）。
我们的数据表明，TIPS 后肝血流明显改善，特别是在 AP，门静脉的血流供应变化与 TIPS 后肝体积的变化呈正相关。增加门静脉向肝脏的供血可能会改善肝体积的减少。
