[The value of magnetic resonance imaging (MRI) for the follow-up of patients with transjugular intrahepatic portosystemic shunts (TIPS)].
OBJECTIVE
To prospectively determine the value of magnetic resonance imaging (MRI) with flow quantification in the portal vein for the follow-up of patients with transjugular intrahepatic portosystemic shunt (TIPS).


METHODS
Thirty-six patients with TIPS (23 m, 13 f) were evaluated with MR of the liver parenchyma and quantification of flow in the portal vein. MR examinations were correlated with Doppler sonography and conventional angiography including measurement of the portal pressure gradient (PPG). In cases of re-interventions (dilatation/stent application) additional examinations with MRI and Doppler sonography were performed.


RESULTS
MR flow measurements in the portal vein correlated with Doppler sonography (r = 0.69) whereas no correlation of both methods with the PPG was found. No threshold velocity in the portal vein could be determined to predict shunt stenosis. All shunt occlusions (n = 5) were diagnosed correctly by MRA. Thirty measurements before and after successful angiographic interventions revealed a significant increase in portal flow velocity and a significant decrease of the PPG. Magnetic resonance images enabled a reliable detection of procedural complications (parenchymal bleedings, n = 31; extra and subcaspular hematomas, n = 2 each) and newly occurring hepatocellular carcinomas (n = 2) in the follow-up period.


CONCLUSIONS
Magnetic resonance imaging in the follow-up of TIPS enables a morphological assessment of the liver and an accurate velocity mapping, but is not suited to predict shunt dysfunction as a single method.
Schlegel
P M
PM
Institut für Klinische Radiologie, Röntgenstr 2002, Germany.
Tombach
B
B
Reimer
P
P
Vestring
T
T
Menzel
J
J
Möller
H E
HE
Heindel
W
W
D000368:Aged; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D011169:Portal Vein / Q000000981:diagnostic imaging; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011446:Prospective Studies; D012372:ROC Curve; D015607:Stents; D018608:Ultrasonography, Doppler