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Ultrasound Med Biol. 2017 Mar;43(3):595-600. doi: 10.1016/j.ultrasmedbio.2016.10.007. Epub 2016 Dec 12.

Time-Harmonic Elastography of the Liver is Sensitive to Intrahepatic Pressure Gradient and Liver Decompression after Transjugular Intrahepatic Portosystemic Shunt (TIPS) Implantation.

Author information

1
Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
2
Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
3
Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: christian.althoff@charite.de.

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.

KEYWORDS:

Blood volume; Hepatic blood flow; Multi-frequency vibration; Portal hypertension; Time harmonic elastography; Transjugular intrahepatic portosystemic shunt

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