Post-TIPS portal venography
demonstrated persistent filling of the IMV-IIV shunt (Figure 1C).
Caption: Figure 2: (a) Portal venography
after initial needle access through DIPS.
Improving image quality in portal venography
with spectral CT imaging.
The stenosis is best confirmed with direct portal venography
via transhepatic puncture, where the pressure gradient across the stricture can also be measured.
Given the undefined nature of the patient's apparent cirrhosis and lack of demonstrable neoplastic liver disease by CT scan, portal venography
and transjugular liver biopsy were performed to assess the potential option of transjugular intrahepatic portosystemic shunt for palliation of her refractory ascites.