Application of dynamic enhanced CT in assessing overt hepatic encephalopathy after creation of transjugular intrahepatic portosystemic shunt
10.3969/j.issn.1008-794X.2025.02.011
- VernacularTitle:动态对比增强CT评价经颈静脉肝内门体分流术后显性肝性脑病的价值
- Author:
Yibo WANG
1
;
Guangsen FENG
;
Mingqin ZHANG
;
Wenhao ZHANG
Author Information
1. 450002 河南郑州 河南省中医院介入放射科
- Keywords:
transjugular intrahepatic portosystemic shunt;
overt hepatic encephalopathy;
portal venous flow distribution
- From:
Journal of Interventional Radiology
2025;34(2):175-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the intrahepatic portal blood flow distribution by using dynamic contrast-enhanced CT(DCE-CT)scan,and to evaluate its application value in preventing overt hepatic encephalopathy(OHE)after transjugular intrahepatic portosystemic shunt(TIPS).Methods The clinical data of 110 patients with digestive tract hemorrhage due to cirrhotic portal hypertension,who received TIPS at Henan Provincial Hospital of Traditional Chinese Medicine of China from July 2017 to November 2023,were retrospectively analyzed.Preoperative DCE-CT was performed to evaluate the type of intrahepatic portal blood flow distribution.In patients with different types of intrahepatic portal blood flow distribution,the incidence of post-TIPS OHE was compared between the patients receiving portal vein left branch shunting and the patients receiving portal vein right branch shunting.Results In patients with the right splenic vein type,the incidences of post-TIPS OHE in left portal branch shunting and right portal branch shunting were 58.3％and 21.1％respectively,and the difference was statistically significant(P=0.022).In patients with the left splenic vein type and the diffuse distribution type,there was no statistically significant difference in the incidence of post-TIPS OHE between left portal branch shunting and right portal branch shunting(P=0.246 and 0.846 respectively).Further subgroup analysis results showed that the incidences of OHE in patients receiving splenic vein dominant branch shunting and in patients receiving superior mesenteric vein dominant branch shunting were 20.8％and 57.9％respectively,and the difference was statistically significant(P=0.008).Conclusion Pre-TIPS DCE-CT evaluation of intrahepatic portal blood flow distribution and intraoperative selective portal vein branch shunting can reduce the risk of postoperative OHE to a certain extent.
