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Monday, January 28, 2019

The Feasibility of Using Volumetric Phase-Contrast MR Imaging (4D Flow) to Assess for Transjugular Intrahepatic Portosystemic Shunt Dysfunction 


Summary


Doppler US evaluation of transjugular intrahepatic portosystemic shunts (TIPS) carries a high false positive rate, but there is no other currently accepted technique for assessing for TIPS dysfunction.
The authors performed a feasibility study to determine if phase-contrast magnetic resonance (MR) angiography (4D flow) could identify the absence or presence of TIPS stenosis or occlusion. They evaluated 23 patient encounters, 16 of which underwent successful segmentation and analysis of the TIPS stent and portal vein. When clinically indicated, venography was performed. In patients who did not undergo venography, clinical follow-up of at least 6 months was used to exclude stenosis. Time-resolved particle tracings were created to model flow through the stent and allow for qualitative assessment of stenosis. Velocities were also measured using 4D flow. Clinical follow-up was obtained by chart review to determine if symptoms returned, repeat intervention was required, or clinical suspicion of stenosis emerged. Lack of recurrent symptoms or need for intervention was recorded at least 6 months after the MR examination to serve as a reference standard in patients who did not undergo venography. In patient encounters with technically successful 4D flow MR imaging, the rate of dysfunction was 3 of 16 patients (19%). The 3 patients with venography-confirmed stenosis had both abnormal velocities on quantitative and qualitative 4D flow MR imaging. False-positive 4D flow MR imaging results occurred in 6 cases but only if the qualitative and quantitative results were interpreted in isolation. There were no false-positive results if criteria for dysfunction included both abnormal qualitative and quantitative results and there were no false negative cases.



Figure 2. Venography-proven TIPS dysfunction. The measured pressure gradient was 18 mmHg. (a) Still image from particle tracing cine imaging of TIPS stent showing the entire stent (double arrow), inferior vena cava(narrow arrow), portal vein (wide arrow), and elevated velocities with aliasing at the distal TIPS stent (arrowhead). (b) Spectral wave Doppler US interrogation of the distal TIPS showing normal velocities. (c)Grayscale and color Doppler US images with inadequately visualized distal TIPS. (d) Digital subtraction venography showing distal TIPS stenosis (arrowhead)

Commentary


The concordance between TIPS Doppler US and venography is relatively poor. Despite this, performing US for TIPS surveillance is the current standard. This study looks at the feasibility of performing phase-contrast MR imaging for evaluation of TIPS. The authors conclude that this technique can detect patency, stenosis, and occlusion of TIPS. Many patient and technical factors must be considered to optimize the MR imaging of TIPS and prevent failures and the authors nicely describe their imaging protocol. A small number of patients were studied and a randomized controlled trial is still required to determine if volumetric phase-contrast MR imaging will prove to be superior to Doppler US, but the results of this feasibility study suggest MR may be a promising alternative modality for TIPS surveillance.

Click here for abstract

Owen, Joseph, et al. The Feasibility of Using Volumetric Phase-Contrast MR Imaging (4D Flow) to Assess for Transjugular Intrahepatic Portosystemic Shunt Dysfunction. Journal of Vascular and Interventional Radiology. December, 2018. Volume 29, Issue 12, Pages 1717–1724.

Post Author
Zagum Bhatti, MD
Assistant Professor
Department of Radiology, Interventional Radiology Division
University of Texas Health Science Center at Houston, Houston, TX
@ZagumBhatti

14 comments:

  1. listen came on this site today and sat down prime live casino Here I was able to relax and have a good time.

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    Replies
    1. i was diagnosed with herpes  for 2 years ago i lived in pain with the knowledge that i wasn't going to ever be well again i contacted so many doctors and visit many hospital on this issue and wasted a large sum of money but my condition never got better i was determined to get my life back so one day i saw miss Katrina post on how Dr ojoka saved her from the same infection with his herbal medicine i contacted Dr ojoka on his email address drojokarootandherbal@gmail.com we spoke on the issue on whats app +2348144172934 i told him all that i went through and he told me not to worry that everything will be fine again so he prepared the medicine and send it to me through courier service and told me how to use it,after 21 days of usage I went to see the doctor for test ,then the result was negative,am the happiest person on earth now. this testimony is real.thanks to Dr ojoka God bless you.  DOCTOR OJOKA CAN AS WELL CURE THE FOLLOWING DISEASE:-
      1. HIV/AIDS
      2. HERPES
      3. CANCER OF ALL KINDS
      4. HPV
      5. Hepatitis A,B,C
      6. Diabetes
      7. HSV1&2 Natural remedies for curing HIV and Herpes call and whats app Dr Ojoka on +2348144172934  check his blog: https://perfectherbalcure.blogspot.com/  

      Delete
    2. I never believed i would be healed from HIV someday. And I have been taking some medication from my doctor and there was no improvement. Few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (HSV 2 and Cancer) by this Man Dr Sayo and she also gave the contact of this man and advise we should contact him for
      any sickness that he would be of help, so i wrote to Dr Sayo telling him about my (Hiv virus ) he told me not to worry that i was going to be cured!! hmm i never believed it, well after all the procedures and remedy given to me by this man
      few weeks later i started experiencing changes all over me as Dr, Sayo assured me that i have cured,after some time i went to my Doctor to confirmed if i have be finally healed, behold! it was TRUE, So friends my advise is if you have such sickness or any other at all
      you can reach Dr Sayo on his email, (sayoherbalhealer@gmail com) .....ALL THANKS TO GOD FB page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/





      I never believed i would be healed from HIV someday. And I have been taking some medication from my doctor and there was no improvement. Few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (HSV 2 and Cancer) by this Man Dr Sayo and she also gave the contact of this man and advise we should contact him for
      any sickness that he would be of help, so i wrote to Dr Sayo telling him about my (Hiv virus ) he told me not to worry that i was going to be cured!! hmm i never believed it, well after all the procedures and remedy given to me by this man
      few weeks later i started experiencing changes all over me as Dr, Sayo assured me that i have cured,after some time i went to my Doctor to confirmed if i have be finally healed, behold! it was TRUE, So friends my advise is if you have such sickness or any other at all
      you can reach Dr Sayo on his email, (sayoherbalhealer@gmail com) .....ALL THANKS TO GOD FB page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/

      Delete
    3. HOW I WAS CURE FROM HERPES WITHIN TWO WEEKS WITH THE HELP OF DR SAYO HERBAL MEDICINE. HIS EMAIL IS SAYOHERBALHEALER@GMAIL.COM

      I am so Happy to be writing this article in here, i am here to explore blogs forum about the wonderful and most safe cure for HERPES SIMPLEX VIRUS . I was positive to the deadly Virus called HERPES and i lost hope completely because i was rejected even by my closet friends. i searched online to know and inquire about cure for HERPES and i saw testimony about Dr Sayo online on how he cured so many persons from Herpes Disease so i decided to contact the great herbalist because i know that nature has the power to heal everything. i contacted him to know how he can help me and he told me never to worry that he will help me with the natural herbs from God! after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via UPS and it got to me after 5days! i used the medicine as he instructed me (MORNING and EVENING) and i was cured! its really like a dream but i'm so happy! that's the reason i decided to also add more comment of Him so that more people can be saved just like me! and if you need his help,contact his Email: sayoherbahealer@gmail.com check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ check website; http://sayoherbalhealer.website2.me/      

      He also have the herb to cure difference cure for any sickness
      (1) HERPES,
      (2) DIABETES,
      (3) HIV&AIDS,
      (4) URINARY TRACT INFECTION,
      (5) HEPATITIS B,
      (6) IMPOTENCE,
      (7) BARENESS/INFERTILITY
      (8) DIARRHEA
      (9) ASTHMA...

      kindly email DR SAYO for your own cure if you have any disease listed above via email: sayoherbalhealer@gmail.com    























      HOW I WAS CURE FROM HERPES WITHIN TWO WEEKS WITH THE HELP OF DR SAYO HERBAL MEDICINE. HIS EMAIL IS SAYOHERBALHEALER@GMAIL.COM

      I am so Happy to be writing this article in here, i am here to explore blogs forum about the wonderful and most safe cure for HERPES SIMPLEX VIRUS . I was positive to the deadly Virus called HERPES and i lost hope completely because i was rejected even by my closet friends. i searched online to know and inquire about cure for HERPES and i saw testimony about Dr Sayo online on how he cured so many persons from Herpes Disease so i decided to contact the great herbalist because i know that nature has the power to heal everything. i contacted him to know how he can help me and he told me never to worry that he will help me with the natural herbs from God! after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via UPS and it got to me after 5days! i used the medicine as he instructed me (MORNING and EVENING) and i was cured! its really like a dream but i'm so happy! that's the reason i decided to also add more comment of Him so that more people can be saved just like me! and if you need his help,contact his Email: sayoherbahealer@gmail.com check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ check website; http://sayoherbalhealer.website2.me/      

      He also have the herb to cure difference cure for any sickness
      (1) HERPES,
      (2) DIABETES,
      (3) HIV&AIDS,
      (4) URINARY TRACT INFECTION,
      (5) HEPATITIS B,
      (6) IMPOTENCE,
      (7) BARENESS/INFERTILITY
      (8) DIARRHEA
      (9) ASTHMA...

      kindly email DR SAYO for your own cure if you have any disease listed above via email: sayoherbalhealer@gmail.com    

      Delete




    4. Just wanna say a big thank you cythia for introducing me to Dr Sayo the great HERBALIST that helped me prepare home remedies that cured my herpes simplex virus (HSV1&2)
      I was infected with herpes for the past two years and i was not happy all day so i was desperate to get a cure so that i can live normal and get healthy.One day i was less busy so i decided to make latest research on herpes  cure  and i found a site were everyone was talking about Dr Sayo and has ability to cure Herpes, HIV, HPV, Cancer, ALS, COPD, Anthrax, genital wart, cold sore, Arthritis skin tag and all manners of diseases and virus.So i discussed with cythia and she explained to me that its very easy working with Dr sayo  so i contacted Dr Sayo via email  dr.sayoherbalhealer@gmail.com and he helped me just as he has helped others now I am  now cured from herpes am very happy now.and i can also assure you that he can also help you. so if you need the service of Dr Sayo kindly contact him visit his websites website; http://sayoherbalhealer.website2.me/ Or check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ 



      Delete




    5. Hello all viewer online HIV has cure but doctor said Hiv/Aids has no cure until i met Dr SAYO who help me in my life. I was infected with HIV/AIDS in 2008, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution, so that my body can be okay. until this faithful day as i was browsing the net I saw a testimony on how Dr.SAYO helped people in curing HIV Disease, quickly I copied his Email which is sayoherbalhealer@gmail.com so i contacted him for solution for my HIV, so Dr.SAYO told me that his going to prepare herbal medicine for my health, then he prepared the medicine and luckily after two week my Hiv/Aids was be cured. Dr SAYO is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr.SAYO herbal medicine, he so cure HERPES,CANCER, ALS,HEPATITIS B, DIABETIC check his FB page:  https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ OR visit his websites website; http://sayoherbalhealer.website2.me/  check blog: https://sayoherbalhealer.blogspot.com/    



















      Hello all viewer online HIV has cure but doctor said Hiv/Aids has no cure until i met Dr SAYO who help me in my life. I was infected with HIV/AIDS in 2008, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution, so that my body can be okay. until this faithful day as i was browsing the net I saw a testimony on how Dr.SAYO helped people in curing HIV Disease, quickly I copied his Email which is sayoherbalhealer@gmail.com so i contacted him for solution for my HIV, so Dr.SAYO told me that his going to prepare herbal medicine for my health, then he prepared the medicine and luckily after two week my Hiv/Aids was be cured. Dr SAYO is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr.SAYO herbal medicine, he so cure HERPES,CANCER, ALS,HEPATITIS B, DIABETIC check his FB page:  https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ OR visit his websites website; http://sayoherbalhealer.website2.me/  check blog: https://sayoherbalhealer.blogspot.com/    












      Delete




    6. THE MOST HIGH AND GREAT SPELL CASTER ONLINE AND CONTACT HIM FOR ANY KIND OF SPELL YOU MAY NEED: DOCTOR0LOVESPELL@GMAIL.COM
      This is the most wonderful thing i have ever experienced. I visited a forum here on the internet on the 17 June 2018, and i saw a marvelous testimonies on the forum about the good works Dr love0. Am from the United States. I never believed it, because have never heard anything about such miracle before. No body would have been able to convince me about it not until Dr love0 did a marvelous work for me that restored my marriage of 4 years by getting back my divorced wife within 48 hours just as i read on the internet. I was truly shocked when my wife came home pleading for forgiveness to accept her back. Am really short of words to show my appreciation to Dr love0. For he's a God sent to me and my entire family for divine restoration of marriage. Are you in need of any help whatsoever? Don't hesitate to get in touch with him now. You can contact him Via email (doctor0lovespell@gmail.com) check his blogs: https://doctorlovespell0.blogspot.com/ or check website: https://doctor0lovespell.wixsite.com/lovespell or visit his FB page: https://www.facebook.com/Love-Spell-Doctor0-107453264273672/ He also specializes on the follow;
      Divorce reconciliation
      Marriage reconciliation
      Business growth
      Promotion in your place of work/office
      Making banks to grants loans
      Cures of diseases such as; Cancer, hiv, aids, herpes E.T.C.
      Getting your EX/lover back
      Getting your wife/husband back
      Getting your boyfriend/girlfriend back




















      THE MOST HIGH AND GREAT SPELL CASTER ONLINE AND CONTACT HIM FOR ANY KIND OF SPELL YOU MAY NEED: DOCTOR0LOVESPELL@GMAIL.COM
      This is the most wonderful thing i have ever experienced. I visited a forum here on the internet on the 17 June 2018, and i saw a marvelous testimonies on the forum about the good works Dr love0. Am from the United States. I never believed it, because have never heard anything about such miracle before. No body would have been able to convince me about it not until Dr love0 did a marvelous work for me that restored my marriage of 4 years by getting back my divorced wife within 48 hours just as i read on the internet. I was truly shocked when my wife came home pleading for forgiveness to accept her back. Am really short of words to show my appreciation to Dr love0. For he's a God sent to me and my entire family for divine restoration of marriage. Are you in need of any help whatsoever? Don't hesitate to get in touch with him now. You can contact him Via email (doctor0lovespell@gmail.com) check his blogs: https://doctorlovespell0.blogspot.com/ or check website: https://doctor0lovespell.wixsite.com/lovespell or visit his FB page: https://www.facebook.com/Love-Spell-Doctor0-107453264273672/ He also specializes on the follow;
      Divorce reconciliation
      Marriage reconciliation
      Business growth
      Promotion in your place of work/office
      Making banks to grants loans
      Cures of diseases such as; Cancer, hiv, aids, herpes E.T.C.
      Getting your EX/lover back
      Getting your wife/husband back
      Getting your boyfriend/girlfriend back



      Delete
  2. I was diagnosed of herpes virus, I have tried all possible means to get cure but all my effort proved abortive, until a friend of mine introduced me to a herbal doctor called Chief Dr Lucky, who prepare herbal medicine to cure all kind of diseases including herpes virus (Herpes), when i contacted this herbal doctor via email, he sent me herpes virus herbal medicine via courier service, when i received the herbal medicine he gave me step by step instructions on how to apply it, when i applied it as instructed i was totally cured from the virus within 3 weeks of usage. Contact this great herbal doctor today to get your cure. 
    Via Email : chiefdrlucky@gmail.com
    Whats App : +2348132777335
    website : http://chiefdrluckysolutionhome.website2.me/  

    ReplyDelete
  3. i was diagnosed with herpes  for 2 years ago i lived in pain with the knowledge that i wasn't going to ever be well again i contacted so many doctors and visit many hospital on this issue and wasted a large sum of money but my condition never got better i was determined to get my life back so one day i saw miss Katrina post on how Dr ojoka saved her from the same infection with his herbal medicine i contacted Dr ojoka on his email address drojokarootandherbal@gmail.com we spoke on the issue on whats app +2348144172934 i told him all that i went through and he told me not to worry that everything will be fine again so he prepared the medicine and send it to me through courier service and told me how to use it,after 21 days of usage I went to see the doctor for test ,then the result was negative,am the happiest person on earth now. this testimony is real.thanks to Dr ojoka God bless you.  DOCTOR OJOKA CAN AS WELL CURE THE FOLLOWING DISEASE:-
    1. HIV/AIDS
    2. HERPES
    3. CANCER OF ALL KINDS
    4. HPV
    5. Hepatitis A,B,C
    6. Diabetes
    7. HSV1&2 Natural remedies for curing HIV and Herpes call and whats app Dr Ojoka on +2348144172934  check his blog: https://perfectherbalcure.blogspot.com/  

    ReplyDelete
  4. I never believed i would be healed from HIV someday. And I have been taking some medication from my doctor and there was no improvement. Few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (HSV 2 and Cancer) by this Man Dr Sayo and she also gave the contact of this man and advise we should contact him for
    any sickness that he would be of help, so i wrote to Dr Sayo telling him about my (Hiv virus ) he told me not to worry that i was going to be cured!! hmm i never believed it, well after all the procedures and remedy given to me by this man
    few weeks later i started experiencing changes all over me as Dr, Sayo assured me that i have cured,after some time i went to my Doctor to confirmed if i have be finally healed, behold! it was TRUE, So friends my advise is if you have such sickness or any other at all
    you can reach Dr Sayo on his email, (sayoherbalhealer@gmail com) .....ALL THANKS TO GOD FB page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/

    ReplyDelete
  5. HOW I WAS CURE FROM HERPES WITHIN TWO WEEKS WITH THE HELP OF DR SAYO HERBAL MEDICINE. HIS EMAIL IS SAYOHERBALHEALER@GMAIL.COM

    I am so Happy to be writing this article in here, i am here to explore blogs forum about the wonderful and most safe cure for HERPES SIMPLEX VIRUS . I was positive to the deadly Virus called HERPES and i lost hope completely because i was rejected even by my closet friends. i searched online to know and inquire about cure for HERPES and i saw testimony about Dr Sayo online on how he cured so many persons from Herpes Disease so i decided to contact the great herbalist because i know that nature has the power to heal everything. i contacted him to know how he can help me and he told me never to worry that he will help me with the natural herbs from God! after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via UPS and it got to me after 5days! i used the medicine as he instructed me (MORNING and EVENING) and i was cured! its really like a dream but i'm so happy! that's the reason i decided to also add more comment of Him so that more people can be saved just like me! and if you need his help,contact his Email: sayoherbahealer@gmail.com check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ check website; http://sayoherbalhealer.website2.me/      

    He also have the herb to cure difference cure for any sickness
    (1) HERPES,
    (2) DIABETES,
    (3) HIV&AIDS,
    (4) URINARY TRACT INFECTION,
    (5) HEPATITIS B,
    (6) IMPOTENCE,
    (7) BARENESS/INFERTILITY
    (8) DIARRHEA
    (9) ASTHMA...

    kindly email DR SAYO for your own cure if you have any disease listed above via email: sayoherbalhealer@gmail.com    

    ReplyDelete





  6. Just wanna say a big thank you cythia for introducing me to Dr Sayo the great HERBALIST that helped me prepare home remedies that cured my herpes simplex virus (HSV1&2)
    I was infected with herpes for the past two years and i was not happy all day so i was desperate to get a cure so that i can live normal and get healthy.One day i was less busy so i decided to make latest research on herpes  cure  and i found a site were everyone was talking about Dr Sayo and has ability to cure Herpes, HIV, HPV, Cancer, ALS, COPD, Anthrax, genital wart, cold sore, Arthritis skin tag and all manners of diseases and virus.So i discussed with cythia and she explained to me that its very easy working with Dr sayo  so i contacted Dr Sayo via email  dr.sayoherbalhealer@gmail.com and he helped me just as he has helped others now I am  now cured from herpes am very happy now.and i can also assure you that he can also help you. so if you need the service of Dr Sayo kindly contact him visit his websites website; http://sayoherbalhealer.website2.me/ Or check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ 








    ReplyDelete
  7. Hello all viewer online HIV has cure but doctor said Hiv/Aids has no cure until i met Dr SAYO who help me in my life. I was infected with HIV/AIDS in 2008, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution, so that my body can be okay. until this faithful day as i was browsing the net I saw a testimony on how Dr.SAYO helped people in curing HIV Disease, quickly I copied his Email which is sayoherbalhealer@gmail.com so i contacted him for solution for my HIV, so Dr.SAYO told me that his going to prepare herbal medicine for my health, then he prepared the medicine and luckily after two week my Hiv/Aids was be cured. Dr SAYO is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr.SAYO herbal medicine, he so cure HERPES,CANCER, ALS,HEPATITIS B, DIABETIC check his FB page:  https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ OR visit his websites website; http://sayoherbalhealer.website2.me/  check blog: https://sayoherbalhealer.blogspot.com/    

    ReplyDelete
  8. THE MOST HIGH AND GREAT SPELL CASTER ONLINE AND CONTACT HIM FOR ANY KIND OF SPELL YOU MAY NEED: DOCTOR0LOVESPELL@GMAIL.COM
    This is the most wonderful thing i have ever experienced. I visited a forum here on the internet on the 17 June 2018, and i saw a marvelous testimonies on the forum about the good works Dr love0. Am from the United States. I never believed it, because have never heard anything about such miracle before. No body would have been able to convince me about it not until Dr love0 did a marvelous work for me that restored my marriage of 4 years by getting back my divorced wife within 48 hours just as i read on the internet. I was truly shocked when my wife came home pleading for forgiveness to accept her back. Am really short of words to show my appreciation to Dr love0. For he's a God sent to me and my entire family for divine restoration of marriage. Are you in need of any help whatsoever? Don't hesitate to get in touch with him now. You can contact him Via email (doctor0lovespell@gmail.com) check his blogs: https://doctorlovespell0.blogspot.com/ or check website: https://doctor0lovespell.wixsite.com/lovespell or visit his FB page: https://www.facebook.com/Love-Spell-Doctor0-107453264273672/ He also specializes on the follow;
    Divorce reconciliation
    Marriage reconciliation
    Business growth
    Promotion in your place of work/office
    Making banks to grants loans
    Cures of diseases such as; Cancer, hiv, aids, herpes E.T.C.
    Getting your EX/lover back
    Getting your wife/husband back
    Getting your boyfriend/girlfriend back

    ReplyDelete