Comparative evaluation of handheld vs. high-end ultrasound systems for TIPSS hemodynamic assessment: first impressions
Year: 2026
Type: article
Abstract: Background Transjugular intrahepatic portosystemic shunt (TIPSS) procedures require reliable post-interventional hemodynamic monitoring to detect shunt dysfunction, for which Doppler ultrasonography is the preferred modality. Owing to the rapid development of handheld ultrasound devices, their diagnostic equivalence to high-end systems warrants investigation. Materials and methods A pilot group of 23 patients ( n = 13 males, 65%; n = 7 females; 35%; n = 3 unknown) with intrahepatic TIPSS were retrospectively analyzed. Blood flow measurements were obtained and compared using a high-end ultrasound system (Resona R9, Mindray) and modern handheld ultrasound device (Vscan Air™ CL, GE). The TIPSS was evaluated using B-mode and color Doppler sonography. Image quality was assessed using a 5-point scale and flow parameters using statistical analysis. The image quality and the difference between the two devices were analyzed using correlation coefficients and multivariable linear regression models including TIPSS flow values, skin-to-TIPSS distance, and TIPSS dwell time. Results Both devices produced clinically interpretable images. However, the high-end device yielded superior image quality in 16 of 23 cases ( p < 0.001). Significant correlations were observed between the difference in mean TIPSS flow measurements obtained by the two devices (Δ mean TIPSS flow) and corresponding average flow values measured by the two devices (Kendall’s τ = 0.656; p < 0.001). Significant associations with Δ TIPSS mean flow were identified for skin-to-TIPSS distance (τ = 0.39; p = 0.014) and TIPSS dwell time (τ = −0.39; p = 0.017). In multivariable analysis, both mean TIPSS flow measured by the high-end system and skin-to-TIPSS distance remained significantly associated with Δ TIPSS mean flow. The TIPSS mean flow measured by the high-end system correlated with TIPSS dwell time (τ = 0.38; p = 0.021). Bland–Altman analysis revealed that handheld measurements tended to overestimate low flows and underestimate high flows. Conclusion Handheld ultrasound devices show promising potential for TIPSS surveillance; however, they could lead to distorted flow deviations. Contemporary handheld devices may nevertheless be useful in selected point-of-care settings but cannot yet replace high-end systems for precise hemodynamic monitoring. Larger prospective studies are required. Trial registration No clinical trial registration was performed, as this study is a single-center retrospective observational analysis based on existing clinical data. The study did not involve prospective patient enrollment, international procedures, or assignment to treatment groups. Therefore, registration in a clinical trial registry was not applicable.
Source: BMC Medical Imaging
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7225826362