Chong W K, Malisch T A, Mazer M J, Lind C D, Worrell J A, Richards W O
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675.
Radiology. 1993 Dec;189(3):789-93. doi: 10.1148/radiology.189.3.8234705.
To evaluate the ability of Doppler ultrasonography (US) to depict the patency of a transjugular intrahepatic portosystemic shunt (TIPS).
Twenty-eight patients were followed up after creation of TIPS with US, angiography, and endoscopy performed at regular intervals. Magnetic resonance (MR) angiography was performed in four patients. US was performed first, and the results were correlated with those at angiography. Measurements of maximum flow velocity (Vmax) were taken from the proximal part of the shunt.
In normal shunts, mean Vmax was 95 cm/sec. Shunt obstruction was seen in 12 cases: occlusion in four and stenosis in eight. All cases of occlusion were detected with US and appeared as absent flow within the shunt. There was one false-positive diagnosis of occlusion. All cases of stenosis resulted in reduced Vmax (mean, 32 cm/sec; P < .001). After successful revision in seven patients, Vmax rose to a mean of 122 cm/sec. Artifact from the metal stent prevented flow assessment with MR imaging.
US can be performed to evaluate shunt status, and Vmax is an accurate noninvasive parameter for assessing shunt patency.
评估多普勒超声检查（US）描绘经颈静脉肝内门体分流术（TIPS）通畅情况的能力。
28例患者在接受TIPS术后接受随访，定期进行US、血管造影和内镜检查。4例患者进行了磁共振（MR）血管造影。首先进行US检查，并将结果与血管造影结果进行对比。从分流道近端测量最大流速（Vmax）。
正常分流道的平均Vmax为95 cm/秒。12例出现分流道阻塞：4例为闭塞，8例为狭窄。所有闭塞病例均通过US检测到，表现为分流道内无血流信号。有1例假阳性闭塞诊断。所有狭窄病例的Vmax均降低（平均为32 cm/秒；P <.001）。7例患者成功修复后，Vmax升至平均122 cm/秒。金属支架产生的伪影妨碍了通过MR成像评估血流情况。
可进行US检查以评估分流道状态，Vmax是评估分流道通畅情况的准确无创参数。
