Utility of Splenic Stiffness as a Noninvasive Tool for Evaluating TIPS: A Reliable and Reproducible Method for Identifying Dysfunction

作者：Sushant Babbar, Yashwant Patıdar, Amar Mukund, Abhinandan Kumar, M Sharma, Shiv Kumar Sarin · 发表于：Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging · 年份：2026 · DOI：10.1055/s-0046-1824599 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Abdominal Surgery and Complications

Abstract The effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in managing adverse effects stemming from portal hypertension has been well-documented, showcasing remarkable outcomes. Direct portal pressure or hepatic venous pressure gradient (HVPG) with venography is the current gold standard for evaluation of TIPS function. These methods being invasive, a search for noninvasive and easily available tool like splenic stiffens as an alternative to look for TIPS function is studied. Twenty-seven patients (19 undergoing fresh TIPS and 8 patients undergoing revision for tips dysfunction) were included. Splenic stiffness (SS) by two-dimensional (2D) shear wave elastography was measured by two observers, and color Doppler ultrasound (CDUS) evaluation was done in all patients 1 day prior to TIPS procedure and on day 1, 3, 28, and 60 postprocedure. A total of 7 patients having TIPS dysfunction were identified at 2 months. For receiver operating characteristic (ROC) curve analysis, mean SS was calculated in 20 patients with normal TIPS function and 15 (8 undergoing TIPS revision and 7 TIPS dysfunction identified during follow-up) TIPS dysfunction patients. SS showed mean decrease of 42.1% immediately postprocedure and 53.5% at 1 month. SS correlated with HVPG (R = 0.57, p = 0.02) and direct portal pressure (R = 0.53, p = 0.004). Portal vein (PV) velocity showed mean increase of 18.6 cm/s 24 hours postprocedure. In univariate analysis, SS, PV velocity, and flow in t...