title: Spleen stiffness and splenoportal venous flow: assessment before and after transjugular intrahepatic portosystemic shunt placement.
abstract: OBJECTIVE
  To prospectively assess changes in spleen stiffness and splenoportal venous flow before and after transjugular intrahepatic portosystemic shunt (TIPS) placement.
  
  
  METHODS
  We prospectively evaluated spleen stiffness measured by the mean shear wave velocity with acoustic radiation force impulse imaging and the splenoportal venous velocity with color Doppler sonography in 12 patients (mean age ± SD, 42.6 ± 11.0 years; range, 29-65 years) who underwent TIPS placement for portal hypertension and gastroesophageal bleeding. The mean shear wave velocity and angle-corrected splenoportal venous velocity at the main portal and splenic veins were measured 1 day before and 3 to 9 days after TIPS placement (mean interval, 6.0 ± 1.95 days; range, 4-10 days) and were compared with portal vein pressure measured during the procedure.
  
  
  RESULTS
  There was a significant difference in portal vein pressure before and after TIPS (25.34 ± 6.21 versus 15.66 ± 6.07 mm Hg; P = .0005). After TIPS, the mean shear wave velocity decreased significantly in all 12 cases (3.50 ± 0.46 versus 3.15 ± 0.39 m/s before and after TIPS; P = .00015). The flow velocity at the main portal vein increased significantly after TIPS (22.21 ± 4.13 versus 47.25 ± 12.37 cm/s; P = .0000051). The splenic vein velocity and spleen index measured 25.57 ± 6.98 cm/s and 55.99 ± 21.27 cm(2), respectively, before TIPS and 35.72 ± 11.10 cm/s and 50.11 ± 21.12 cm(2) after TIPS (P = .0004 and .003).
  
  
  CONCLUSIONS
  A significant decrease in the mean shear wave velocity and increase in the splenoportal venous velocity occurred with reduced portal vein pressure after TIPS placement. Hence, both parameters can be used as noninvasive quantitative markers for monitoring TIPS function after placement.
authors: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors: Hai-Tao
authors: HT
authors: Ran
authors: Xiao-Ping
authors: XP
authors: Ye
authors: Yuan-Yi
authors: YY
authors: Zheng
authors: Da-Zhi
authors: DZ
authors: Zhang
authors: Zhi-Gang
authors: ZG
authors: Wang
authors: Johnson
authors: J
authors: Chen
authors: David
authors: D
authors: Madoff
authors: Jing
authors: J
authors: Gao
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012039:Regional Blood Flow; D013154:Spleen / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015607:Stents; D018615:Ultrasonography, Doppler, Color