COLOR DOPPLER SONOGRAPHY OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS (TIPS)

Transjugular intrahepatic portosystemic shunts (TIPS) have largely rep laced surgically created shunts in the treatment of life-threatening s equelae of portal venous hypertension [1-5], Conventional duplex and c olor Doppler sonography are proving to be useful tools in the assessme nt of the stents and their associated hemodynamic changes [2-5]. A tho rough Doppler survey before and immediately after TIPS placement provi des a baseline for evaluation of shunt function and procedure-related complications. Routine follow-up studies at regular intervals after th e procedure provide noninvasive assessment of shunt patency and late c omplications, This pictorial essay illustrates the anatomic and hemody namic abnormalities present with portal hypertension before TIPS and d iscusses the expected duplex and color Doppler findings after TIPS. Th e sonographic characteristics of immediate and delayed complications, as well as potential diagnostic pitfalls, are discussed.