Primary Clinical Study Of Non-Invasive Evaluation On Therapeutic Effect Of Transjugular Intrahepatic Portosystemic Shunt And Percutaneous Transhepatic Varices Embolization Using Acoustic Structure Quantification Method And Virtual Touch Tissue Quantificat

PART I PRIMARY CLINICAL STUDY OF NON-INVASIVE EVALUATION ON THERAPEUTIC EFFECT OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT AND PERCUTANEOUS TRANSHEPATIC VARICES EMBOLIZATION USING ACOUSTIC STRUCTURE QUANTIFICATION METHODObjective:To explore the feasibility of ASQ parametric images and ASQ parameters of the liver and the spleen with acoustic structure quantification (ASQ) technique in noninvasive assessment of transjugular intrahepatic portosystemic stent shunt (TIPSS) and percutaneous transhepatic varices embolization (PTVE)Methods:Thirty normal subjects and thirty patients who underwent TIPSS and PTVE for treatment of portal hypertension (PHTN) were enrolled in this study. ASQ parametric images and ASQ parameters of the liver and the spleen were obtained by ASQ.The portal vein pressure was measured while placing the TIPSS 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 was compared. The correlation between ASQ Parameters of the spleen and the liver and portal venous pressure was analysed.Results:There was significant difference in portal vein pressure pre (28.71±4.81) mmHg and post (18.30±4.73)mmHg TIPSS and PTVE(P<0.05).The ASQ quantitative parameters of the Spleen in healthy subjects, patients with PHTN pre and post TIPSS and PTVE increased progressively and the difference between the groups was statistically significant (P<0.05).The difference of the ASQ quantitative parameters of the liver between healthy subjects and patients with PHTN pre TIPSS and PTVE was significant (P<0.05).There was no significant difference of the ASQ quantitative parameters of the liver between pre and post TIPSS and PTVE (P>0.05).Significantly linear correlation (r=0.299,0.331,0.451, 0.848,0.961,0.318 and 0.881, all P<0.05) was found between the ASQ quantitative parameters of the spleen (Red Mode、Red Ave、Red SD、FD ratio、Blue Mode、Blue Ave、Blue SD) and portal vein pressure. 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).Conclusions:The ASQ quantitative parameters of the spleen had statistically significant correlation with portal vein pressure. 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 TIPSS and PTVE. However, evidence to support a similar role for the ASQ quantitative parameters of liver was lacking.PART Ⅱ PRIMARY CLINICAL STUDY OF SPLEEN SHEAR WAVE VELOCITY USING VIRTUAL TOUCH TISSUE QUANTIFICATION FOR NONINVASIVE ASSESSMENT OF THERAPEUTIC EFFECT OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT AND PERCUTANEOUS TRANSHEPATIC VARICES EMBOLIZATIONObjective:To evaluate the efficacy of the spleen shear wave velocity (SSWV) using virtual touch tissue quantification (VTQ) technique in noninvasive assessment of transjugular intrahepatic portosystemic stent shunt (TIPS) and percutaneous transhepatic varices embolization (PTVE)Methods:Nineteen patients who underwent TIPS and PTVE for treatment of PHTN were enrolled. Patients in study group were divided into two groups, the group A with the patient who underwent TIPS and PTVE for treatment of PHTN (n=13) and the group B with patient who underwent in two TIPS and PTVEs (n=6). SSWV were obtained by VTQ technique one day before TIPS and PTVE and 6 days after TIPS and PTVE. The portal vein pressure was measured while placing the TIPS and PTVE. The correlation between SSWV and portal venous pressure was analysed.Results:The portal vein pressure after TIPS and PTVE decreased significantly both in study group A and in study group B compared with the pre-treatment group (all P<0.05). Six days after TIPS and PTVE, SSWV significantly decreased both in study group A and in study group B compared with that for one day before TIPS and PTVE (all P＜0.05). SSWV both in study group A and study group-B were positively correlated with portal vein pressure (all P＜0.05).Conclusions:The SSWV measured with VTQ which positively correlated with portal vein pressure could be used as a quantitative marker in monitoring the portal vein pressure pre and post TIPS and PTVE.