TY  - JOUR
A1  - Bernatz, Simon
A1  - Weitkamp, Inga
A1  - Scholtz, Jan-Erik
A1  - Koch, Vitali
A1  - Grünewald, Leon David
A1  - Mader, Christoph
A1  - Ackermann, Jörg
A1  - Albrecht, Moritz Hans Ernst
A1  - Martin, Simon S.
A1  - Vogl, Thomas J.
A1  - Mahmoudi, Scherwin
T1  - Quantitative analysis of in-TIPS thrombosis in abdominal CT
T2  - European Journal of Radiology Open
N2  - Purpose: To identify transjugular intrahepatic portosystemic shunt (TIPS) thrombosis in abdominal CT scans applying quantitative image analysis.
Materials and methods: We retrospectively screened 184 patients to include 20 patients (male, 8; female, 12; mean age, 60.7 ± 8.87 years) with (case, n = 10) and without (control, n = 10) in-TIPS thrombosis who underwent clinically indicated contrast-enhanced and unenhanced abdominal CT followed by conventional TIPS-angiography between 08/2014 and 06/2020. First, images were scored visually. Second, region of interest (ROI) based quantitative measurements of CT attenuation were performed in the inferior vena cava (IVC), portal vein and in four TIPS locations. Minimum, maximum and average Hounsfield unit (HU) values were used as absolute and relative quantitative features. We analyzed the features with univariate testing.
Results: Subjective scores identified in-TIPS thrombosis in contrast-enhanced scans with an accuracy of 0.667 – 0.833. Patients with in-TIPS thrombosis had significantly lower average (p < 0.001), minimum (p < 0.001) and maximum HU (p = 0.043) in contrast-enhanced images. The in-TIPS / IVC ratio in contrast-enhanced images was significantly lower in patients with in-TIPS thrombosis (p < 0.001). No significant differences were found for unenhanced images. Analyzing the visually most suspicious ROI with consecutive calculation of its ratio to the IVC, all patients with a ratio < 1 suffered from in-TIPS thrombosis (p < 0.001, sensitivity and specificity = 100%).
Conclusion: Quantitative analysis of abdominal CT scans facilitates the stratification of in-TIPS thrombosis. In contrast-enhanced scans, an in-TIPS / IVC ratio < 1 could non-invasively stratify all patients with in-TIPS thrombosis.
KW  - Transjugular Intrahepatic Portosystemic Shunt
KW  - TIPS
KW  - In-TIPS thrombosis
KW  - Quantitative Imaging
KW  - CT
KW  - Angiography
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78291
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-782912
SN  - 2352-0477
VL  - 9
IS  - 100405
PB  - Elsevier
CY  - Amsterdam
ER  -