Color Doppler imaging of portosystemic shunts

AJR. American Journal of Roentgenology
E G GrantR W Busuttil

Abstract

This study was designed to investigate the utility of color Doppler sonography in the evaluation of portosystemic shunts. Thirty-one patients with a total of 32 shunts were imaged. The types of shunts examined included portacaval, five; mesocaval, eight; distal splenorenal (Warren), 14; and mesoatrial, five. Sonography was performed without knowledge of the status of the shunt, although the type of shunt was known before beginning the study. The sonographic studies were evaluated to determine their sensitivity and specificity on the basis of a prospective comparison with angiography or MR imaging (22 cases). The possible advantages of color Doppler over duplex Doppler sonography in evaluating portosystemic shunts were also investigated, as was the ability of color Doppler sonography to image specifically the shunt anastomoses. Color Doppler sonography successfully inferred shunt patency (17 cases) or thrombosis (five cases) in all 22 shunts for which correlative imaging was available (sensitivity = 100%, specificity = 100%). In comparing duplex with color Doppler sonography in all 32 shunts, the two techniques were almost equally effective in establishing patency in portacaval, mesocaval, and mesoatrial shunts. Duplex Doppler s...Continue Reading

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