Transjugular intrahepatic portosystemic shunt: Accuracy of helical CT angiography in the detection of shunt abnormalities
Transjugular intrahepatic portosystemic shunt: Accuracy of helical CT angiography in the detection of shunt abnormalities
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DOI：
10.1148/radiology.215.1.r00ap51115
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发表时间：
2000-04-01
期刊：
影响因子：
19.7
通讯作者：
Ghiatas, AA
中科院分区：
文献类型：
--
作者：
Chopra, S;Dodd, GD;Ghiatas, AA
目的：确定螺旋计算机断层扫描 (CT) 血管造影检测经颈静脉肝内门体分流 (TIPS) 狭窄或闭塞的敏感性、特异性和准确性。 材料和方法：37 名患者接受了 50 次螺旋 CT 血管造影检查，并在每次检查后 2 周内进行门静脉造影并测量门体压力梯度。螺旋 CT 血管造影由三名对门静脉造影结果不知情的放射科医生独立解读。比较螺旋CT血管造影和门静脉造影的结果。分别计算螺旋 CT 血管造影的敏感性和特异性，以显示形态异常并确定其血流动力学意义。 结果：在 50 个门静脉造影中，31 个（62%）显示形态学 TIPS 异常，24 个（77%）有门体压力梯度升高，7 个（23%）没有门体压力梯度升高。螺旋 CT 血管造影正确显示了 31 种形态异常中的 30 种 (97%)，并正确诊断了 24 种血流动力学显着异常中的 22 种 (92%)。十九 (38%) 门静脉造影结果正常；螺旋 CT 血管造影正确地证明了其中 17 例（90%）病例没有异常。螺旋 CT 血管造影对所有形态异常的敏感性和特异性分别为 97% 和 89%，对血流动力学显着异常的敏感性和特异性分别为 92% 和 77%。 结论：螺旋 CT 血管造影有望作为检测 TIPS 狭窄或闭塞的筛查方式。
PURPOSE: To determine the sensitivity, specificity and accuracy of helical computed tomographic (CT) angiography in the detection of transjugular intrahepatic portosystemic shunt (TIPS) stenoses or occlusions.MATERIALS AND METHODS: Thirty-seven patients underwent 50 helical CT angiographic examinations and, within 2 weeks of each examination, portography with measurement of the portosystemic pressure gradient. Helical CT angiograms were independently interpreted by three radiologists who were blinded to the results of portography. Results of helical CT angiography and portography were compared. Sensitivity and specificity of helical CT angiography were separately calculated for the demonstration of morphologic abnormalities and the determination of their hemodynamic significance.RESULTS: Of the 50 portograms, 31 (62%) demonstrated morphologic TIPS abnormalities, 24 (77%) with and seven (23%) without elevated portosystemic pressure gradients. Helical CT angiograms correctly demonstrated 30 (97%) of the 31 morphologic abnormalities and allowed correct diagnosis of 22 (92%) of the 24 hemodynamically significant abnormalities. Nineteen (38%) portograms were normal; helical CT angiograms correctly demonstrated the absence of a abnormality in 17 (90%) of these cases. Sensitivity and specificity of helical CT angiography for all morphologic abnormalities were 97% and 89%, respectively, and, for hemodynamically significant abnormalities, 92% and 77%.CONCLUSION: Helical CT angiography holds promise as a screening modality for the detection of TIPS stenoses or occlusions.