Contrast-enhanced ultrasound: a new method for TIPS follow-up

Micol, C.; Marsot, Julien; Boublay, Nawèle; Pilleul, F.; Berthezène, Yves; Rode, Agnès

doi:10.1007/s00261-011-9763-4

Cited by 25 publications

(19 citation statements)

References 27 publications

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“…On the other hand, CEUS is characterized by some limitations that also apply to the unenhanced conventional technique. For example, attenuation because of the deep position of the stent, and obesity and bowel gas can affect the imaging [24]. However, in our experience, as long as adequate intestinal preparation is accomplished, CEUS is easy to perform, and good image quality can be obtained.…”

Section: Discussionmentioning

confidence: 87%

“…With the use of contrast agents, CEUS overcomes angular dependence and the shortcoming of DUS by increasing the signal-to-noise ratio [24]. Blood ow is easy to depict with contrast material, and the visualization of the ISR is more intuitive by contrast agent lling defects.…”

Section: Discussionmentioning

confidence: 99%

“…However, its accuracy for the detection of iliac vein lesions is still controversial [22]. Contrast-enhanced ultrasound (CEUS) uses injected microbubbles as intravascular contrast and has been successfully used in the evaluation of endoleaks post EVAR [23] and TIPS follow-up [24]. To the best of our knowledge, the value of CEUS in the diagnosis of iliac vein stent stenosis has not been previously reported.…”

Section: Introductionmentioning

confidence: 99%

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Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting

Liu

Wang

Zhao

et al. 2020

Preprint

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Background: To compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method.Methods: Patients with iliac vein obstructive disease treated with nitinol stents between January 2016 and December 2017 were consecutively included in this study. DUS, CEUS, and MDCTV were carried out in all patients within one week of each other at one year post stenting to investigate the presence of stent compression and in-stent restenosis (ISR). Results: The study included 139 patients (87 females; mean age 58 ± 15 years). For detecting stent compression, the kappa coefficient between the ultrasound modality of gray-scale imaging and MDCTV was 0.901, indicating very good agreement between these two modalities. ISR was detected in 50, 61, and 65 patients by DUS, CEUS, and MDCTV, respectively. DUS and CEUS (kappa=0.449) and DUS and MDCTV (kappa=0.516) had moderate agreement for ISR diagnosis, while for which CEUS and MDCTV (kappa 0.884) had very good agreement. The sensitivity, specificity, positive and negative predictive values of DUS and CEUS for diagnosing ISR were 63.1% and 90.8%, 87.8% and 97.3%, 82.0% and 96.7%, and 73.0% and 92.3%, respectively.Conclusions: CEUS is superior to DUS in terms of diagnostic accuracy for the follow-up of patients with iliac vein stent stenosis.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting

Liu

Wang

Zhao

et al. 2020

Preprint

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“…With covered devices, the hepatic venous outflow of the TIPS tract is the major site of subsequent obstruction [14], [28]. Although the clinical application of covered stent-grafts has improved the primary patency rates after TIPS procedures [5], [6], the one-year patency was reported to be still limited, even as low as 38% [29].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have also demonstrated that the hepatic venous outflow is the primary site of stenosis when covered stent are used to construct the TIPS [13], [14]. To overcome this problem, the current practice is to extend the outflow ends of the stent-grafts from the TIPS tract into inferior vena cava (IVC).…”

Section: Introductionmentioning

confidence: 99%

MRI-Monitored Intra-Shunt Local Agent Delivery of Motexafin Gadolinium: Towards Improving Long-Term Patency of TIPS

et al. 2013

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BackgroundTransjugular intrahepatic portosystemic shunt (TIPS) has become an important and effective interventional procedure in treatment of the complications related to portal hypertension. Although the primary patency of TIPS has been greatly improved due to the clinical application of cover stent-grafts, the long-term patency is still suboptimal. This study was to investigate the feasibility of using magnetic resonance imaging (MRI)-monitored intra-shunt local agent delivery of motexafin gadolinium (MGd) into shunt-vein walls of TIPS. This new technique aimed to ultimately inhibit shuntstenosis of TIPS.MethodologyHuman umbilical vein smooth muscle cells (SMCs) were incubated with various concentrations of MGd, and then examed by confocal microscopy and T1-map MRI. In addition, the proliferation of MGd-treated cells was evaluated. For in vivo validation, seventeen pigs underwent TIPS. Before placement of the stent, an MGd/trypan-blue mixture was locally delivered, via a microporous balloon, into eleven shunt-hepatic vein walls under dynamic MRI monitoring, while trypan-blue only was locally delivered into six shunt-hepatic vein walls as serve as controls. T1-weighted MRI of the shunt-vein walls was achieved before- and at different time points after agent injections. Contrast-to-noise ratio (CNR) of the shunt-vein wall at each time-point was measured. Shunts were harvested for subsequent histology confirmation.Principal FindingsIn vitro studies confirmed the capability of SMCs in uptaking MGds in a concentration-dependent fashion, and demonstrated the suppression of cell proliferation by MGds as well. Dynamic MRI displayed MGd/blue penetration into the shunt-vein walls, showing significantly higher CNR of shunt-vein walls on post-delivery images than on pre-delivery images (49.5±9.4 vs 11.2±1.6, P<0.01), which was confirmed by histology.ConclusionResults of this study indicate that MRI-monitored intra-shunt local MGd delivery is feasible and MGd functions as a potential therapeutic agent to inhibit the proliferation of SMCs, which may open alternative avenues to improve the long-term patency of TIPS.

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Hepatic Angiography and Vascular Interventional Radiology

Pauro

Lupi

Mattolin

et al. 2020

Imaging of the Liver and Intra-Hepatic Biliary Tract

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Contrast-enhanced ultrasound: a new method for TIPS follow-up

Abstract: CEUS allows direct visualization of intra-prosthetic flow, with a qualitative and anatomic study, in addition to the Doppler examination. This is a new, simple, and effective technique for TIPS follow-up.

Cited by 25 publications

References 27 publications

Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting

Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting

MRI-Monitored Intra-Shunt Local Agent Delivery of Motexafin Gadolinium: Towards Improving Long-Term Patency of TIPS

Hepatic Angiography and Vascular Interventional Radiology

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