关键词: 肝硬化, 经颈静脉肝内门体分流术, 彩色多普勒超声, 超声造影, 支架功能

Abstract: Objective The aim of this study was to investigate the feasibility of color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in evaluating stent function after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 111 consecutive patients with hepatitis B-induced LC were encountered in our hospital between January 2021 and September 2024, portal hypertension (PH) was found in 53 cases (47.7%) based on hepatic venous pressure gradient(HVPG) measurement, and TIPS was conducted in 44 cases. Color Doppler ultrasonography was performed to record portal vein blood flow velocity (PVV), portal vein diameter (PVD) and portal vein blood flow (PVF), and CEUS was done to record time-intensity curve (TIC) for time to arrival (TOA), time to peak (TTP) and peak intensity(PI). Results PVV in patients with PH was (13.2±3.1)cm/s, much lower than [(15.9±3.5)cm/s, P<0.05], while PVD and PVF were (1.5±0.4)cm and (605.2±74.3)ml/min, both much wider or greater than [(1.3±0.2)cm and (502.0±47.1)ml/min, respectively, P<0.05] in those without PH; the portal parameters improved in PH patients after TIPS; TOA and TTP in PH group were (15.2±4.7)s and (35.7±6.4)s, both much quicker than [(13.7±3.5)s and (29.0±5.1)s, respectively, P<0.05], while the PI was (17.3±4.1)dB, much lower than [(23.1±4.6)dB, P<0.05] in those without PH; the TIC parameters improved in PH group after TIPS, not significantly different compared to patients without PH (P>0.05); six months after TIPS, stent dysfunction proven by digital subtraction angiography (DSA) was found in 7 cases (15.9%) out of 44 patients receiving TIPS, and the diagnostic consistence was satisfactory by ultrasonography and CEUS, with the sensitivity of 85.7%, specificity of 89.2% and accuracy of 88.6%. Conclusion Combination of color Doppler ultrasound and CEUS provides a reliable clinical tools for evaluating post-TIPS stent function in patients with hepatitis B-induced LC, and is worthy of widespread clinical application.

Key words: Liver cirrhosis, Transjugular intrahepatic portosystemic shunt, Color Doppler ultrasound, Contrast-enhanced ultrasound, Stent function