Dual Source CT Evaluation of Thrombosis Formation after Transjugular Intrahepatic Portosystemic Shunt_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 PENGLi-qing ¹ , ZHANGXiao ² , HUANGZi-xing ¹ ,  YUJian-qun ¹ , FANGZhi-jia ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
2. CT/MRI Room, Leshan People's Hospital, Leshan 614000, Sichuan Province, China;

Corresponding?author：

YUJian-qun, Email: cjr.yujianqun@vip.163.com

Keywords：

Cirrhosis; Portal hypertension; Transjugular intrahepatic portosystemic shunt; Thrombosis

DOI：

10.7507/1007-9424.20160325

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the CT findings and causes of thrombosis formation after transjugular intrahepatic portosystemic shunt (TIPS). Methods One hundred forty-two patients with cirrhosis after TIPS were included. The imaging features of thrombus in the stent after TIPS were recorded and causes of thrombosis formation were analyzed. The presence, location and amount of thrombus, the location of ends of TIPS stent were analyzed. Results The incidence of thrombosis formation after TIPS was 19.0% (27/142). The thrombus could locate around the upper end (7.4%), lower end (18.6%) of the stent and inside the stent (74.0%), there was significant differences in the incidence of stent thrombosis in different locations (P < 0.05). The thrombus might presented as little mural thrombus (12/27, 44.4%), marked thrombus (3/27, 11.1%) and thrombotic occlusion (12/27, 44.4%), there was a significant difference in the incidence of stent thrombosis with different thrombus volume (P < 0.05). There were stent outlet vascular stenosis in most patients with stent thrombosis (88.9%). Conclusions Stent thrombosis after TIPS is common. Dual source computed tomography angiography could evaluate the thrombotic features. Stent outlet vascular stenosis might be associated with thrombosis formation after TIPS.

Citation： PENG Li-qing, ZHANG Xiao, HUANG Zi-xing, YU Jian-qun, FANG Zhi-jia. Dual Source CT Evaluation of Thrombosis Formation after Transjugular Intrahepatic Portosystemic Shunt. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(10): 1268-1271. doi: 10.7507/1007-9424.20160325 Copy

1.	Heinzow HS,Lenz P,Köhler M,et al. Clinical outcome and predictors of survival after TIPS insertion in patients with liver cirrhosis. World J Gastroenterol,2012, 18(37):5211-5218.
2.	Kim HK,Kim YJ,Chung WJ, et al. Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension:Korean multicenter real-practice data. Clin Mol Hepatol,2014,20(1):18-27.
3.	韓浩, 楊建, 諸葛宇征, 等. 彩色多普勒超聲對經頸靜脈肝內門體分流術后支架功能障礙的診斷價值. 臨床超聲醫學雜志, 2015, 17(8):522-525.
4.	Peng LQ, Yu JQ, Yang ZG, et al. Left atrial diverticula in patients referred for radiofrequency ablation of atrial fibrillation:assessment of prevalence and morphologic characteristics by dual-source computed tomography. Circ Arrhythm Electrophysiol, 2012, 5(2):345-350.
5.	王榮品, 劉昌杰, 鄧奇平, 等. 雙源CT一站式掃描診斷急性肺栓塞與深靜脈血栓. 中國醫學影像技術, 2011, 27(12):2476-2479.
6.	張青, 鮮軍舫, 燕飛, 等. CT增強掃描評價急慢性門靜脈系統血栓. 臨床薈萃, 2014, 29(6):651-657.
7.	陳志明, 呂梁, 李文佳, 等. 雙源CT在經頸靜脈門腔分流術后隨訪中的應用. 中國醫學影像技術, 2011, 27(8):1626-1628.
8.	褚建國, 黃鶴. 經頸靜脈肝內門腔靜脈支架分流術中門靜脈分流支血管的選擇及其臨床意義. 中華介入放射學電子雜志, 2013, 1(1):36-39.
9.	Geeroms B, Laleman W, Laenen A, et al. Expanded polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunts in cirrhotic patients:long-term patency and clinical outcome results. Eur Radiol, 2016 Sep 15.[Epub ahead of print].
10.	Menichini C, Xu XY. Mathematical modeling of thrombus formation in idealized models of aortic dissection:initial findings and poten tial applications. J Math Biol, 2016 Mar 23.[Epub ahead of print].
11.	Ho H, Sorrell K, Peng L, et al. Hemodynamic analysis for transjugular intrahepatic portosystemic shunt (TIPS) in the liver based on a CT-image. IEEE Trans Med Imaging, 2013, 32(1):92-98.
12.	Janiga G, Daróczy L, Berg P, et al. An automatic CFD-based flow diverter optimization principle for patient-specific intracranial aneurysms. J Biomech. 2015, 48(14):3846-3852.
13.	Landgraf BR, Johnson KM, Roldán-Alzate A, et al. Effect of temporal resolution on 4D flow MRI in the portal circulation. J Magn Reson Imaging, 2014, 39(4):819-826.
14.	周洪煜, 公丕運, 杜學森, 等. 脾靜脈血栓對血流動力學影響的分析及計算流體力學模擬. 生物醫學工程學雜志, 2015, 32(1):43-47.
15.	George SM, Eckert LM, Martin DR, et al. Hemodynamics in normal and diseased livers:application of image-based computational models. Cardiovasc Eng Technol, 2015, 6(1):80-91.
16.	Li X, Wang XK, Chen B, et al. Computational hemodynamics of portal vein hypertension in hepatic cirrhosis patients. Biomed Mater Eng, 2015, 26 Suppl 1:S233-S243.
17.	Ho H, Bartlett A, Hunter P. Hemodynamic simulation for an anatomically realistic portal system. Med Image Comput Comput Assist Interv, 2011, 14(Pt 1):347-354.
18.	Balasubramanian P, Boopathy V, Govindasamy E, et al. Assessment of portal venous and hepatic artery haemodynamic variation in non-alcoholic fatty liver disease (NAFLD) patients. J Clin Diagn Res, 2016, 10(8):TC07-TC10.
19.	Owens CA,Bartolone C,Warner DL, et al. The inaccuracy of duplex ultrasonography in predicting patency of transjugular intrahepatic portosystemic shunts.Gastroenterology, 1998, 114(5):975-980.
20.	Benito A,Bilbao J,Hernández T, et al. Doppler ultrasound for TIPS:does it work? Abdom Imaging, 2004, 29(1):45-52.
21.	韓浩,楊建,吳敏,等. 經頸靜脈肝內門體分流術對門靜脈血流動力學變化的超聲評價.江蘇醫藥, 2014, 40(8):970-971.
22.	陳家飛, 李蓮, 李榮軍. 3D旋轉DSA在TIPS中的臨床應用. 局解手術學雜志, 2011, 20(5):588.
23.	Flohr TG, Leng S, Yu L, et al. Dual-source spiral CT with pitch up to 3.2 and 75 ms temporal resolution:image reconstruction and assessment of image quality. Med Phys, 2009, 36(12):5641-5653.
24.	朱洪基, 余建群, 彭禮清,等. 小兒急性闌尾炎的雙源CT評價. 中國普外基礎與臨床雜, 2015, 22(07):875-878.
25.	錢蓉, 袁元, 黃子星, 等. 雙源CT雙能量掃描碘圖對急性胰腺炎早期壞死灶的診斷價值.中國普外基礎與臨床雜志, 2015, 22(3):357-360.
26.	袁元, 李真林, 楊行, 等. 雙源CT低劑量掃描在上腹部增強檢查中的應用. 中國普外基礎與臨床雜志, 2012, 19(5):556-561.

1. Heinzow HS,Lenz P,Köhler M,et al. Clinical outcome and predictors of survival after TIPS insertion in patients with liver cirrhosis. World J Gastroenterol,2012, 18(37):5211-5218.
2. Kim HK,Kim YJ,Chung WJ, et al. Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension:Korean multicenter real-practice data. Clin Mol Hepatol,2014,20(1):18-27.
3. 韓浩, 楊建, 諸葛宇征, 等. 彩色多普勒超聲對經頸靜脈肝內門體分流術后支架功能障礙的診斷價值. 臨床超聲醫學雜志, 2015, 17(8):522-525.
4. Peng LQ, Yu JQ, Yang ZG, et al. Left atrial diverticula in patients referred for radiofrequency ablation of atrial fibrillation:assessment of prevalence and morphologic characteristics by dual-source computed tomography. Circ Arrhythm Electrophysiol, 2012, 5(2):345-350.
5. 王榮品, 劉昌杰, 鄧奇平, 等. 雙源CT一站式掃描診斷急性肺栓塞與深靜脈血栓. 中國醫學影像技術, 2011, 27(12):2476-2479.
6. 張青, 鮮軍舫, 燕飛, 等. CT增強掃描評價急慢性門靜脈系統血栓. 臨床薈萃, 2014, 29(6):651-657.
7. 陳志明, 呂梁, 李文佳, 等. 雙源CT在經頸靜脈門腔分流術后隨訪中的應用. 中國醫學影像技術, 2011, 27(8):1626-1628.
8. 褚建國, 黃鶴. 經頸靜脈肝內門腔靜脈支架分流術中門靜脈分流支血管的選擇及其臨床意義. 中華介入放射學電子雜志, 2013, 1(1):36-39.
9. Geeroms B, Laleman W, Laenen A, et al. Expanded polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunts in cirrhotic patients:long-term patency and clinical outcome results. Eur Radiol, 2016 Sep 15.[Epub ahead of print].
10. Menichini C, Xu XY. Mathematical modeling of thrombus formation in idealized models of aortic dissection:initial findings and poten tial applications. J Math Biol, 2016 Mar 23.[Epub ahead of print].
11. Ho H, Sorrell K, Peng L, et al. Hemodynamic analysis for transjugular intrahepatic portosystemic shunt (TIPS) in the liver based on a CT-image. IEEE Trans Med Imaging, 2013, 32(1):92-98.
12. Janiga G, Daróczy L, Berg P, et al. An automatic CFD-based flow diverter optimization principle for patient-specific intracranial aneurysms. J Biomech. 2015, 48(14):3846-3852.
13. Landgraf BR, Johnson KM, Roldán-Alzate A, et al. Effect of temporal resolution on 4D flow MRI in the portal circulation. J Magn Reson Imaging, 2014, 39(4):819-826.
14. 周洪煜, 公丕運, 杜學森, 等. 脾靜脈血栓對血流動力學影響的分析及計算流體力學模擬. 生物醫學工程學雜志, 2015, 32(1):43-47.
15. George SM, Eckert LM, Martin DR, et al. Hemodynamics in normal and diseased livers:application of image-based computational models. Cardiovasc Eng Technol, 2015, 6(1):80-91.
16. Li X, Wang XK, Chen B, et al. Computational hemodynamics of portal vein hypertension in hepatic cirrhosis patients. Biomed Mater Eng, 2015, 26 Suppl 1:S233-S243.
17. Ho H, Bartlett A, Hunter P. Hemodynamic simulation for an anatomically realistic portal system. Med Image Comput Comput Assist Interv, 2011, 14(Pt 1):347-354.
18. Balasubramanian P, Boopathy V, Govindasamy E, et al. Assessment of portal venous and hepatic artery haemodynamic variation in non-alcoholic fatty liver disease (NAFLD) patients. J Clin Diagn Res, 2016, 10(8):TC07-TC10.
19. Owens CA,Bartolone C,Warner DL, et al. The inaccuracy of duplex ultrasonography in predicting patency of transjugular intrahepatic portosystemic shunts.Gastroenterology, 1998, 114(5):975-980.
20. Benito A,Bilbao J,Hernández T, et al. Doppler ultrasound for TIPS:does it work? Abdom Imaging, 2004, 29(1):45-52.
21. 韓浩,楊建,吳敏,等. 經頸靜脈肝內門體分流術對門靜脈血流動力學變化的超聲評價.江蘇醫藥, 2014, 40(8):970-971.
22. 陳家飛, 李蓮, 李榮軍. 3D旋轉DSA在TIPS中的臨床應用. 局解手術學雜志, 2011, 20(5):588.
23. Flohr TG, Leng S, Yu L, et al. Dual-source spiral CT with pitch up to 3.2 and 75 ms temporal resolution:image reconstruction and assessment of image quality. Med Phys, 2009, 36(12):5641-5653.
24. 朱洪基, 余建群, 彭禮清,等. 小兒急性闌尾炎的雙源CT評價. 中國普外基礎與臨床雜, 2015, 22(07):875-878.
25. 錢蓉, 袁元, 黃子星, 等. 雙源CT雙能量掃描碘圖對急性胰腺炎早期壞死灶的診斷價值.中國普外基礎與臨床雜志, 2015, 22(3):357-360.
26. 袁元, 李真林, 楊行, 等. 雙源CT低劑量掃描在上腹部增強檢查中的應用. 中國普外基礎與臨床雜志, 2012, 19(5):556-561.

Previous Article
腹腔鏡膽囊切除術意外膽囊癌22例報道
Next Article
Research Status and Application Prospect of Personalizing Pancreatic Cancer Organoids in The Era of Precision Medicine

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Dual Source CT Evaluation of Thrombosis Formation after Transjugular Intrahepatic Portosystemic Shunt

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content