Transjugular intrahepatic portosystemic shunt stenosis
Hepatic cirrhosis with TIPS insertion 2 weeks ago. Abdominal distension and dyspnea.
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There is evidence of aliasing at the IVC side of the TIPS.
The velocity at the portal side measures 73 cm/sec and at the distal (hepatic vein) portion of the TIPS where the aliasing is seen, the velocity measures around 280 cm/sec which is diagnostic of stenosis.
The main portal vein is patent showing hepatopetal flow, however the portal vein branches are thrombosed.
Marked volume of ascites could be seen.
Normal TIPS velocity ranges from 90-190 cm/sec. Velocity >190 cm/sec is diagnostic of stenosis, with a drop in flow distal to a stenosis.
Here in this case the velocity exceeds 280 cm/sec. Colour aliasing at this site also aids diagnosis.