Study Of The Application Of Ultrasonography Pre-and Post-TIPS

BackgroundCirrhosis is the end stage of many forms of liver injury. Advanced hepatic cirrhosisis accompanied by a hyperdynamic circulatory state and portal hypertension. Many severe complications of cirrhosis are secondary to portal hypertension. The transjugular intrahepatic portosystemic shunt (TIPS) is an interventional treatment resulting in decompression of the portal system by creation of a side-to-side portosystemic anastomosis, and color doppler ultrasonography (CDUS) is a routine means to detect the hemodynamic changes of portal vein and its brunches.Hepatic encephalopathy is a common complication that develops after creation of TIPS. Many studies have been carried out to reveal the risk factors, but most of them were not coherent. We tried to educe some clue of this question by detecting the hemodynamic changes of portal vein with CDUS. Does the systemic hemodynamic state change after TIPS? As kidney is a representative organ which could reflect systemic hemodynamic state, we observed the blood perfusion of kidney pre and post TIPS, to reveal whether renal function can benefit from TIPS? ObjectiveBased on summarizing the outcoming of the scholars in the world, using colorDoppler flow imaging and power Doppler imaging, we observed the changes of the flow direction ( hepatopetal or hepatofugal ) of portal vein and/or its branch, combined with other clinical data, to reveal the relations between these changes and hepatic encephalopathy accompanied with TIPS. We also observed the changes of blood perfusion in kidneies pre- and post-TIPS, combined with the biochemical indices of blood, to investigate the relation between renal function changes and TIPS.Subjects and Methods1. A total of 62 patients (53 males and 9 females )underwent TIPS placement at our hospital between March 1998 and May 2005 were enrolled in our test.