Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS

Ni Zhao; Anya Shi; Weile Huang; Jianan He; Dashuai Wang; Yongyu Zhang; Hui Guo; Bin Zhou; Hairun Gan; Pengfei Pang

doi:10.1016/j.ejrad.2024.111875

Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS

Eur J Radiol. 2024 Dec 4:183:111875. doi: 10.1016/j.ejrad.2024.111875. Online ahead of print.

Authors

Ni Zhao¹, Anya Shi¹, Weile Huang¹, Jianan He¹, Dashuai Wang¹, Yongyu Zhang¹, Hui Guo¹, Bin Zhou², Hairun Gan³, Pengfei Pang⁴

Affiliations

¹ Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China.
² Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China. Electronic address: zhoubsums@163.com.
³ Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China. Electronic address: ganhr1013@163.com.
⁴ Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China.

PMID: 39671727
DOI: 10.1016/j.ejrad.2024.111875

Abstract

Purpose: To describe portal vein cannulation under adjunct guidance for transjugular intrahepatic portosystemic shunts (TIPS).

Methods: Medical records of 86 patients who underwent TIPS, including conventional TIPS, 3D volumetric CT image fusion (CT-fluoroscopy image fusion)-guided TIPS, and trans-abdominal ultrasound (US)-guided TIPS at our institute from March 2016 to June 2024 were reviewed. Baseline characteristics, clinical outcomes, and procedural data were analyzed.

Results: Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and trans-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, p = 0.012). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.

Conclusions: CT-fluoroscopy image fusion and trans-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. These methods provide shorter procedural time and lower contrast usage for TIPS placement.

Keywords: 3D CT image fusion guidance; Efficacy; Portal vein cannulation; Transjugular intrahepatic portosystemic shunts; Ultrasound guidance.