DOPPLER ULTRASOUND ASSESSMENT OF TIPS PATENCY AND FUNCTION - THE NEEDFOR ECHO ENHANCERS

Purpose. The aim of this study was to illustrate the versatility of an i.v. administered echo enhancer for Doppler US assessment of TIPS pat ency and function. Material and Methods: A total of 22 Doppler US eval uations of TIPS patency and function were performed in 5 patients with alcoholic cirrhosis and recurrent oesophageal bleeding who had been t reated with TIPS. TIPS patency was evaluated by means of colour or pow er Doppler US. The volume flow (VF) was assessed in the TIPS and in th e portal vein by spectral Doppler. The ratio of the VF in the TIPS to the VF in the portal vein (TIP ratio) was used to express the function al status of the TIPS. If Doppler signals were inconclusive or absent, echo-enhanced US was performed. Results: In 22 follow-up Doppler US e xaminations, echo-enhanced Doppler US was required in 7 cases (29%). T he Doppler enhancement persisted in the range of 3-5 min. No adverse e ffects were observed. An apparently normal TIPS function reflected a T IP ratio in the range of 0.44-1.10, median 0.78+/-0.20 (2SD). Conclusi on: The i.v, administration of echo enhancers would seem to be indicat ed in the assessment of the TIPS function if conventional Doppler US f ails to prove normal TIPS patency and function. The TIP ratio may be a convenient monitoring parameter for reflecting the TIPS function.