Non-invasive evaluation on therapeutic effect of transjugular intrahepatic portosystemic shunt and percutaneous transhepatic varices embolization using acoustic structure quantification method

Abstract:

Objective：To explore the diagnostic value of acoustic structure quantification（ASQ） technique in noninvasive assessment of transjugular intrahepatic portosystemic stent（TIPS） and per－cutaneous transhepatic varices embolization（PTVE）. Methods：Quantitative assessment of 30 normal subjects and 30 patients who underwent TIPS and PTVE for treatment of portal hyper－tension（PHTN）was held by ASQ. The portal vein pressure was measured while placing the TIPS and PTVE. ASQ parameters of the plural，mean，standard deviation，the ratio of blue and red color histogram curve area and the chi-square value were com－pared. The correlation between ASQ parameters of the spleen and the liver and portal venous pressure was analyzed. Results：There were significant differences in portal vein pressure pre and post TIPS and PTVE（P<0.05）. ASQ quantitative parameters were Red Mode，Red Ave，Red SD，FD ratio，Blue Mode，Blue Ave，Blue SD. The values of ASQ quantitative parameters of the spleen were high－er in PHTN pre TIPS and PTVE group than in health control group （P<0.05）. The values of ASQ quantitative parameters of the spleen were higher in PHTN pre TIPS and PTVE group than in post TIPS and PTVE group（P<0.05）. There was no difference in val－ues of ASQ quantitative parameters of the live pre and post TIPS and PTVE （P>0.05）. Significant linear correlation was found be－tween the ASQ quantitative parameters of the spleen and portal vein pressure（r=0.299，0.331，0.451，0.848，0.961，0.318 and 0.881，all P<0.05）. But the ASQ quantitative parameters of liver were not correlated with the portal venous pressure（r=0.194，0.174，0.045，0.169，0.128，0.105 and 0.136，all P>0.05）. There were significant differences in spleen index between healthy subjects and patients with PHTN（P<0.05），as well as between pre and post TIPS and PTVE（P<0.05）. Conclusion：The ASQ quantitative parameters of the spleen could be used as non-invasive method for quantitatively monitoring the change of portal vein pressure pre and post the TIPS and PTVE.