University of Wisconsin–Madison

Evaluation of Vascular Flow Patterns in the Liver in Patients with Portal Hypertension with PC VIPR MRI Pre- and Post-TIPS Implantation

March 2012 to February 2013

Portal hypertension is the most common and lethal complication of end-stage chronic liver disease. One of the most severe complications is development of portosystemic collaterals (varices) that shunt blood from the portal vein. Rupture of gastro-esophageal varices is associated with an overall mortality of up to 34%. Portal pressure is assessed using catheter-based measurements of the hepatic venous pressure gradient (HVPG). Most therapies reduce portal pressure through reductions in the blood flow to the liver (e.g. beta-blockers) or shunting flow from the portal circulation via transjugular intrahepatic portosystemic shunt (TIPS). HVPG is the best-validated biomarker of portal hypertension, but only provides a global measure of disease and only evaluates the gradient between the pressure in the portal vein and the inferior vena cava. A definite statement on the pressure in varices and therapeutic effects on certain vessels is not possible with this method. In this project we aim to evaluate portal hypertension with PCVIPR flow measurements in various vessels before and after TIPS implantations as well as the long term results with measurements after several months.

This project led by: Scott B Reeder, MD, PhD