Transjugular intrahepatic portosystemic shunt: correlation of portal vein velocity measurements and portosystemic pressure gradients.

ABSTRACT

To assess the relationship between portal vein velocity measurements and portosystemic gradients, color Doppler sonography was performed on 12 patients before and after transjugular intrahepatic portosystemic shunt placement. An additional patient was examined before and after shunt modification. The average maximum portal vein velocity increased from 15.7 cm s-1 before shunt placement to 43.5 cm s-1 after shunt placement, while the average portosystemic gradient decreased from 22.0 mm Hg before shunt placement to 7.9 mm Hg after shunt placement. Flow was observed within the shunt in 11 of the 12 cases. Shunt velocity was measurable in nine patients, with an average value of 115.7 cm s-1. Reversal of intrahepatic portal vein flow was observed in 10 cases following shunt placement. Color Doppler sonography is a useful non-invasive tool in the evaluation of intrahepatic portosystemic shunts, and changes in portal vein velocity correlate well with changes in the portosystemic gradient.