High resolution flow with glazing flow for optimized flow detection in transjugular intrahepatic portosystemic stent shunt (TIPS): First results

Clin Hemorheol Microcirc. 2022;82(3):231-238. doi: 10.3233/CH-221427.

Abstract

Background: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft.

Objective: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS.

Methods: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts). In all cases, an experienced examiner performed the examinations with a 1-6 MHz probe (Resona 7, Mindray).

Results: 61 ultrasound examinations in 48 patients were performed; the mean patient age was 54±14.2 years. The use of HR-Flow with Glazing Flow resulted in an improved flow display in 55/61 cases (90.2%). Both methods correlated well (r = 0.71), but HR flow with Glazing flow values were in general higher than CCDS values. The reading resulted in an average value of 2.52±0.54 for CCDS and 3.52±0.57 for HR flow with Glazing flow (p = 0.013).

Conclusion: The combination of HR-Flow and Glazing Flow results in improved flow representation and reduction of artifacts in the ultrasound follow-up of TIPS.

Keywords: HR-flow; Transjugular intrahepatic shunt (TIPS); color coded doppler sonography (CCDS); glazing flow; postinterventional control.

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity
  • Hemodynamics*
  • Humans
  • Middle Aged
  • Portal Vein*
  • Retrospective Studies
  • Stents
  • Treatment Outcome