title: Time-Harmonic Elastography of the Liver is Sensitive to Intrahepatic Pressure Gradient and Liver Decompression after Transjugular Intrahepatic Portosystemic Shunt (TIPS) Implantation.
abstract: We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear wave speed (SWS) measured by multi-frequency time-harmonic ultrasound elastography (THE) before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation. Ten patients with ascites, cirrhotic liver disease and portal hypertension were prospectively examined with invasive HVPG measurement and THE before and after TIPS implantation. HVPG and SWS decreased after TIPS placement from 20.4 ± 2.2 mmHg to 9.8 ± 4.1 mmHg (mean ± standard deviation) and from 3.87 ± 0.54 m/s to 3.27 ± 0.44 m/s. Mean reduction HVPG was -10.6 ± 3.7 mmHg, p < 0.001; mean reduction SWS was -0.60 ± 0.29 m/s, p < 0.001. A linear correlation was observed between HVPG and SWS (R = 0.59, p = 0.0061). THE-measured SWS is a first potential direct ultrasound marker for liver decompression following TIPS in ascites-associated cirrhotic liver disease and therefore might be suitable to non-invasively detect portal hypertension.
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Tzschätzsch
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Sack
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Stephan Rodrigo
authors.initials: SR
authors.lastname: Marticorena Garcia
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Selcan
authors.initials: S
authors.lastname: Ipek-Ugay
authors.affiliation: Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Braun
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: christian.althoff@charite.de.
authors.forename: Christian E
authors.initials: CE
authors.lastname: Althoff
mesh_terms: D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging / Q000601:surgery; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000601:surgery; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000601:surgery*; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome
keywords: Blood volume; Hepatic blood flow; Multi-frequency vibration; Portal hypertension; Time harmonic elastography; Transjugular intrahepatic portosystemic shunt