Document Detail


Transmitted cardiac pulsations as an indicator of transjugular intrahepatic portosystemic shunt function: initial observations.
MedLine Citation:
PMID:  12091687     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine if cardiac pulsations are visible and quantifiable on spectral waveforms during Doppler ultrasonographic (US) evaluation of transjugular intrahepatic portosystemic shunts (TIPS), and if so, whether their magnitude declines with shunt dysfunction. MATERIALS AND METHODS: Baseline and pre-revision US images obtained in 15 patients with venographically confirmed TIPS malfunction were retrospectively examined for spectral waveform pulsation. Cardiac pulsatility was quantified by using the venous pulsatility index (VPI), the venous equivalent of resistive index. VPIs were obtained at four locations from the main portal vein to the stent-hepatic venous junction. Baseline and follow-up examination results in 11 patients with functional TIPS acted as controls and were evaluated similarly. Baseline and follow-up mean VPIs at all four locations were compared for both sets of patients by using the Newman-Keuls pairwise multiple sample comparison test. The chi(2) test was used to determine if a VPI threshold that would result in an acceptable sensitivity and specificity for shunt dysfunction existed. RESULTS: One hundred twenty mean VPIs were obtained in the study group, and 88 mean VPIs were obtained in the control group. Pre-revision VPIs at each location were significantly lower (P <.01) than all baseline values and than the follow-up values in the control group. A VPI less than 0.16 was 94% sensitive and 87% specific for shunt dysfunction. CONCLUSION: The VPI, a quantitative measure of cardiac pulsation obtained with Doppler US, may be a useful parameter for assessing TIPS function.
Authors:
Robert G Sheiman; Thomas Vrachliotis; David P Brophy; Bernard J Ransil
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Radiology     Volume:  224     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-01     Completed Date:  2002-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. rsheiman@caregroup.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Heart / physiology
Humans
Male
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic*
Pulse*
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Doppler*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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