title: Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function: A Pilot Study.
abstract: OBJECTIVE
  To assess the feasibility of splenic shear wave elastography in monitoring transjugular intrahepatic portosystemic shunt (TIPS) function.
  
  
  METHODS
  We measured splenic shear wave velocity (SWV), main portal vein velocity (PVV), and splenic vein velocity (SVV) in 33 patients 1 day before and 3 days to 12 months after TIPS placement. We also measured PVV, SVV, and SWV in 10 of 33 patients with TIPS dysfunction 1 day before and 3 to 6 days after TIPS revision. Analyses included differences in portosystemic pressure gradient (PPG), PVV, SVV, and mean SWV before and after TIPS procedures; comparison of median SWV before and after TIPS procedures; differences in PVV, SVV, and SWV before and at different times up to 12 months after TIPS placement; accuracy of PVV, SVV, and SWV in determining TIPS dysfunction; and correlation between PPG and SWV.
  
  
  RESULTS
  During 12 months of follow-up, 23 of 33 patients had functioning TIPS, and 10 had TIPS dysfunction. The median SWV was significantly different before and after primary TIPS placement (3.60 versus 3.05 m/s; P = .005), as well as before and after revision (3.73 versus 3.06 m/s; P = .003). The PPG, PVV, and SVV were also significantly different before and after TIPS placement and revision (P < .001). The PPG and SWV decreased, whereas PVV and SVV increased, after successful TIPS procedures. A positive correlation was observed between PPG and SWV (r = 0.70; P < .001), and a negative correlation was observed between PPG and PVV and SVV (r = -0.65; P < .001). The areas under the receiver operating characteristic curve for PVV, SVV, and SWV in determining TIPS dysfunction were 0.82, 0.84, and 0.81, respectively.
  
  
  CONCLUSIONS
  Splenic SWV is compatible with splenoportal venous velocity in quantitatively monitoring TIPS function and determining TIPS dysfunction.
authors.affiliation: Department of Radiology, Well Cornel Medical College, New York, New York USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.affiliation: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China zhengxiao618716@yahoo.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Yuan-Yi
authors.initials: YY
authors.lastname: Zheng
authors.affiliation: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Zuo
authors.affiliation: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Ran
authors.affiliation: Department of Radiology, Well Cornel Medical College, New York, New York USA.
authors.forename: Yong Ho
authors.initials: YH
authors.lastname: Auh
authors.affiliation: City University of New York, School of Public Health, Hunter College, New York, New York USA.
authors.forename: Levi
authors.initials: L
authors.lastname: Waldron
authors.affiliation: City University of New York, School of Public Health, Hunter College, New York, New York USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Chan
authors.affiliation: Institute of Ultrasound Imaging, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012372:ROC Curve; D013154:Spleen / Q000000981:diagnostic imaging*
keywords: Doppler sonography; shear wave velocity; spleen stiffness; transjugular intrahepatic portosystemic shunt; ultrasound elastography