Quantitative analysis of in-TIPS thrombosis in abdominal CT

  • 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.

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Author:Simon BernatzORCiDGND, Inga Weitkamp, Jan-Erik ScholtzGND, Vitali KochORCiDGND, Leon David GrünewaldORCiDGND, Christoph MaderORCiDGND, Jörg AckermannORCiDGND, Moritz Hans Ernst AlbrechtORCiDGND, Simon S. MartinORCiDGND, Thomas J. VoglORCiDGND, Scherwin MahmoudiGND
Parent Title (English):European Journal of Radiology Open
Place of publication:Amsterdam
Document Type:Article
Date of Publication (online):2022/02/23
Date of first Publication:2022/02/23
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/10/23
Tag:Angiography; CT; In-TIPS thrombosis; Quantitative Imaging; TIPS; Transjugular Intrahepatic Portosystemic Shunt
Article Number:100405
Page Number:8
Informatik und Mathematik / Informatik
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International