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首页> 外文期刊>Radiology >Transjugular intrahepatic portosystemic shunts: accuracy of Doppler US in determination of patency and detection of stenoses.
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Transjugular intrahepatic portosystemic shunts: accuracy of Doppler US in determination of patency and detection of stenoses.

机译：经颈静脉肝内门体分流术：多普勒超声在确定通畅性和狭窄的检测中的准确性。

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PURPOSE: To evaluate the accuracy of Doppler ultrasonography (US) in determination of patency and detection of stenosis in transjugular intrahepatic portosystemic shunts (TIPS). MATERIALS AND METHODS: Retrospective review was performed of 251 Doppler sonograms obtained in 79 patients who underwent TIPS placement. Sonograms were evaluated for (a) the presence of a spectral waveform or color flow signal within the shunt, (b) the maximum peak flow velocity (Vmax) measured at the midportion of the TIPS, and (c) the direction of intraparenchymal portal venous flow. Independent review was performed of 116 transjugular portal venograms obtained after TIPS placement. RESULTS: Doppler US showed TIPS occlusion in 25 of 26 (96%) cases and confirmed patency in 192 of 193 (99%) cases. Low Vmax within the TIPS (< 50 cm/sec) correlated to a diameter stenosis of 50% or greater at angiography in 25 of 32 (78%) stenotic cases and was not present in 71 of 72 (99%) cases in which no hemodynamically significant stenosis was seen. An interval change in direction of intraparenchymal portal venous flow from hepatofugal to hepatopetal was seen in association with TIPS stenoses in all stenotic cases and was not found in 24 of 26 (92%) cases in which stenosis was not seen. CONCLUSION: Doppler US allows accurate determination of TIPS patency. A Vmax of 50 cm/sec or less within the shunt and interval change from hepatofugal to hepatopetal intraparenchymal portal venous flow are reliable indicators of stenosis.
机译：目的：评估多普勒超声检查（US）在经颈静脉内肝门系统分流术（TIPS）中通畅性和狭窄检测的准确性。材料与方法：回顾性分析了79例行TIPS手术的患者的251张多普勒超声图。对超声图进行评估（a）在分流器内是否存在光谱波形或色彩流动信号;（b）在TIPS中部测得的最大峰值流速（Vmax）;以及（c）实质内门静脉的方向流。在放置TIPS后对116例经颈静脉门静脉造影进行了独立审查。结果：多普勒超声显示26例病例中有25例（96％）TIPS闭塞，而193例病例中有192例（99％）证实通畅。 TIPS内的低Vmax（<50 cm / sec）与32例（78％）狭窄病例中的25例在血管造影时直径狭窄为50％或更大有关，而72例（99％）的71例中没有71例不存在血流动力学显着狭窄。在所有狭窄病例中，与TIPS狭窄相关的实质性肝内门静脉血流向肝瓣间静脉血流方向发生间隔变化，在26例未发现狭窄的病例中有24例未发现（24％）。结论：多普勒超声可以准确测定TIPS通畅性。分流内的Vmax小于或等于50 cm / sec，以及从肝叶到肝实质间门静脉血流的间隔变化是狭窄的可靠指标。

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