Transjugular intrahepatic portosystemic shunts (TIPS): effects of respiratory state and patient position on the measurement of Doppler velocities.

Published

Journal Article

OBJECTIVE: The purpose of this prospective study was to examine the effects of patient position and respiratory state on the measurements of Doppler velocities in transjugular intrahepatic portosystemic shunts. SUBJECTS AND METHODS: Thirty-eight transjugular intrahepatic portosystemic shunts in 34 consecutive patients were studied using Doppler sonography. Peak velocities were measured in the mid shunt with the patient in three positions (supine, sitting upright, and left lateral decubitus) and two respiratory states (deep inspiration and quiet respiration). A mixed linear regression model was used to assess statistically significant differences among the six velocity measurements. RESULTS: Peak velocities in the mid stent averaged 22 cm/sec greater in quiet respiration than in deep inspiration, which was a significant difference (p < 0.00001). Differences in velocities in the three patient positions were not significant (p = 0.53). Using 90-190 cm/sec as the normal range, the peak velocity shifted from normal to abnormal levels by changing respiratory state in 17 (45%) of 38 studies. Using 60 cm/sec as the lower normal limit, the peak velocity fell below the normal range with inspiration in 10 (26%) of 38 studies. In 12 (32%) of 38 studies, a decline in peak velocity exceeding 50 cm/sec could be induced by inspiration. CONCLUSION: Peak systolic velocity in transjugular intrahepatic portosystemic shunts is substantially altered by the respiratory state of the patient at the time of the measurement, but not by the patient position. Respiratory state must be taken into account in the interpretation of peak velocity for shunt stenosis.

Full Text

Duke Authors

Cited Authors

  • Kliewer, MA; Hertzberg, BS; Heneghan, JP; Suhocki, PV; Sheafor, DH; Gannon, PA; Paulson, EK

Published Date

  • July 2000

Published In

Volume / Issue

  • 175 / 1

Start / End Page

  • 149 - 152

PubMed ID

  • 10882265

Pubmed Central ID

  • 10882265

International Standard Serial Number (ISSN)

  • 0361-803X

Digital Object Identifier (DOI)

  • 10.2214/ajr.175.1.1750149

Language

  • eng

Conference Location

  • United States