Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

Figure 2

A representative case of shunt restenosis. This was from a 42 y/o male patient, who was diagnosed with hepatitis B-related liver cirrhosis and had suffered from gastrointestinal bleeding 2 weeks before hospitalization. (a) Coronal image of MRPV showed severe cirrhosis and portal hypertension leading to gastric coronary vein varices and splenomegaly. (b) Biopsy with the forceps before balloon dilation of the shunt under X-ray (the arrow pointed at the tip of the forceps). (c) Angiography showed that TIPS was performed successfully after the biopsy, with no procedure-related complications. (d) Angiography after 16 months of TIPS showed that the shunt was totally occluded. (e) The transverse image of CT after 16 months of TIPS highlighted the positon of the stent and revealed that the cirrhosis was still severe. (f) Pathological diagnosis demonstrated the widespread intralobular bridging necrosis with multiple hepatic lobules involved (arrow), which meant stage III inflammation (H&E staining, ×100).

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