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[Follow-up of TIPS: evaluation of signs of dysfunction with Doppler ultrasonography]
T Puttemans1, B E Van Beers, P Goffette
1Département d'Imagerie Médicale, Cliniques Universitaires Saint-Luc-UCL, Belgique.
Purpose:
to assess the signs of TIPS dysfunction at Doppler sonography.
Materials And Methods:
retrospective study of signs observed in 106 TIPS including 31 TIPS with dysfunction (portoauricular pressure gradient > 12 mmHg).
Results:
the signs of TIPS dysfunction were a decrease in the mean velocity in the TIPS (for a velocity < 40 cm/sec, 90% sensitivity, 96%), a hepatopetal intrahepatic portal flow (on the right 90% sensitivity, 100% specificity, on the left 95% sensitivity, 92% specificity), a lack of cardiac modulation of the signal in the TIPS (93% sensitivity, 65% specificity), a hepatic vein flow reversal (30% sensitivity, 100% specificity), and, the only direct sign of stenosis, an increase of the mean velocity in the stenosis (42% sensitivity, 95% specificity for a velocity > or = 1 m/sec).
Conclusion:
the most sensitive Doppler signs of tips dysfunction are the indirect signs of stenosis.