彩色多普勒超声评估肝硬化门静脉高压症患者TIPS术后支架功能研究*

doi:10.3969/j.issn.1672-5069.2024.06.025

Abstract

Abstract: Objective The aim of this study was to investigate assessment of stent function by color Doppler ultrasonography in patients with liver cirrhosis (LC) and portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS). Methods 136 patients with LC were enrolled in our hospital between January 2020 and December 2022, and PH was defined as hepatic venous pressure gradient (HVPG)≥10 mmHg. Color Doppler ultrasonography was used to measure portal vein blood flow velocity (Vpv), portal vein diameter (Dpv) and portal vein blood flow (Qpv), and receiver operating characteristic (ROC) curve was applied to evaluate diagnostic efficacy of portal vein hemodynamic indicator combination in predicting PH. TIPS was performed routinely, and postoperative stent functions was assessed by color Doppler ultrasonography and digital subtraction angiography (DSA). Results Of 136 patients with LC in our series, PH was found in 62 cases(45.6%) based on HVPG measurement and 52 of them received TIPS; Vpv in patients with LC and PH was (13.1±2.3)cm/s, much lower than [(15.9±3.2)cm/s, P<0.05], while Dpv and Qpv were (1.3±0.3)cm and (626.8±106.8)mL/min, both much higher than [(1.1±0.2)cm and (499.9±97.2)mL/min, P<0.05] in cirrhotics without PH, and portal hemodynamic indicators restored to almost normal and showing no significant differences as compared to those in patients without PH [(16.2±2.5)cm/s, (1.1±0.2)cm and (502.1±99.4)mL/min, respectively, P<0.05]; ROC analysis showed that the AUC was 0.902(95%CI:0.849-0.955,P<0.05), with sensitivity (Se) of 79.0%, specificity (Sp) of 83.8%, when combination of Vpv, Dpv and Qpv in predicting PH; by end of one year follow-up in 52 patients after TIPS, DSA found stent dysfunction in 8 cases (15.4%), and consistency of ultrasonography was satisfactory (Kappa=0.680, P<0.05), with Se of 87.5%, Sp of 90.9%, and accuracy of 90.4%. Conclusion Color Doppler ultrasound has a good application in identifying stent dysfunction after TIPS in patients with LC and PH.

Key words: Liver cirrhosis, Portal hypertension, Color Doppler ultrasonography, Transjugular intrahepatic portosystemic shunt, Stent function, Diagnosis

Chen Siyan, Guo Daoning, Zou Xiaopan, et al. Assessment of stent function by color Doppler ultrasonography in patients with liver cirrhosis and portal hypertension after transjugular intrahepatic portosystemic shunt[J]. Journal of Practical Hepatology, 2024, 27(6): 899-902.

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Assessment of stent function by color Doppler ultrasonography in patients with liver cirrhosis and portal hypertension after transjugular intrahepatic portosystemic shunt

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