Follow-up of TIPSS by colour-coded duplex sonography with use of signal enhancer. Improvement of sonomorphology and detection of stenoses: first results

A study was performed to determine the visualization of the transjugular in tra hepatic portosystemic stent shunt(TIPSS) and the detection of stenosis by the use of a capillary transversing signal enhancer. In 37 patients 37 c olour-coded duplex sonographies were performed before and after intravenous injection of the ultrasound signal enhancer Levovist(R) (Schering, Berlin) . The examinations were evaluated using a four-category score. Special atte ntion was paid to the detection of stenoses in the TIPSS. Transjugular port al venograms of the same day were used as gold standard. The use of Levovis t(R) provided better colour and flow signals for the portal vein end of the shunt in only 9 of 37 sonograms and for the hepatic vein end of the shunt in 37 of 39 sonograms. Eleven of 13 stenoses requiring reintervention in po rtal venography could be correctly identified with signal enhancer. Eleven of these 13 stenoses were located in the hepatic vein end of the shunt. Ult rasound signal enhancer can significantly improve the sonomorphological vis ualization especially of the hepatic vein end of TIPSS in colour-coded dupl ex sonography. Stenoses which usually occur in the hepatic vein end of the shunt may be better detected.