Comparative study of conventional ultrasound and contrast-enhanced ultrasound in quantitative evaluation of the efficacy of transjugular intrahepatic portosystemic shunt in patients with cirrhotic portal hypertension
Objective To quantitatively evaluate the efficacy of transjugular intrahepatic portosystemic shunt(TIPS)in patients with cirrhotic portal hypertension(PHT)by conventional ultrasound and contrast-enhanced ultrasound(CEUS),and to compare and analyze the clinical value.Methods A total of 85 cases of PHT patients treated with TIPS in our hospital were selected.All patients underwent conventional ultrasound examination and CEUS examination 1 d before TIPS and 1 month after TIPS.The portal vein diameter(PVD),splenic vein diameter(SVD),superior mesenteric vein diameter(SMVD),portal vein flow velocity(PVV),splenic vein flow velocity(SVV),superior mesenteric vein flow velocity(SMVV),arrival time(AT),time to peak(TTP),peak intensity(PI),ascending branch slope(AS)before and after TIPS were obtained.The portosystemic pressure gradient(PPG)measured by guideline recommendation before and after TIPS was obtained.The differences of the above parameters before and after TIPS in PHT patients were compared.Pearson correlation analysis was used to analyze the relationship between conventional ultrasound and CEUS parameters before TIPS and PPG after TIPS in PHT patients.Results Conventional ultrasound showed that there were no significant difference in PVD,SVD,SMVD,PVV,SVV,SMVV before and after TIPS in PHT patients.CEUS showed that AT and TTP of PHT patients after TIPS were shorter than those before TIPS,while PI and AS were higher than those before TIPS,with statistically significant differences(all P<0.05).The PPG of PHT patients before and after TIPS were(31.76±6.28)mmHg(1 mmHg=0.133 kPa)and(13.42±2.03)mmHg,respectively,and the difference was statistically significant(t=25.619,P<0.05).Pearson correlation analysis showed that AT and TTP before TIPS were positively correlated with PPG after TIPS(both P<0.05),while PI and AS were negatively correlated with PPG after TIPS(both P<0.05).Conclusion Compared with conventional ultrasound,CEUS could better quantitatively evaluate the changes of portal vein pressure in PHT patients before and after TIPS,which has good clinical value in the short-term efficacy evaluation after TIPS.
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