Transjugular intrahepatic portosystemic shunt (TIPS) can treat portal hypertensive complications and modifies hepatic hemodynamics. Modification of liver perfusion can alter contrast enhancement dynamics of liver nodules. This study investigated the diagnostic performance of contrast-enhanced ultrasound (CEUS) to diagnose hepatocellular carcinoma (HCC) in cirrhosis with TIPS. In this prospective monocentric observational study, CEUS was used to characterize focal liver lesions in patients at risk for HCC with and without TIPS. Times of arterial phase hyperenhancement (APHE) und washout were quantified. Perfusion-index (PI) and resistance-index (RI) of hepatic artery and portal venous flow parameters were measured via doppler ultrasonography. Diagnostic gold standard was MRI/CT or histology. This study included 49 liver lesions [23 TIPS (11 HCC), 26 no TIPS (15 HCC)]. 26 were diagnosed as HCC by gold standard. Sensitivity and specificity of CEUS to diagnose HCC with and without TIPS were 93.3% and 100% vs. 90.9% and 93.3%, respectively. APHE appeared significantly earlier in patients with TIPS compared to patients without TIPS. TIPS significantly accentuates APHE of HCC in CEUS. CEUS has good diagnostic performance for diagnosis of HCC in patients with TIPS.

经颈静脉肝内门体分流术（TIPS）可以治疗门静脉高压并发症并改变肝脏血流动力学。肝脏灌注的改变可以改变肝脏结节的对比增强动力学。本研究调查了超声造影 (CEUS) 使用 TIPS 诊断肝硬化肝细胞癌 (HCC) 的诊断性能。在这项前瞻性单中心观察性研究中，使用 CEUS 来表征有或没有 TIPS 的 HCC 风险患者的局灶性肝脏病变。动脉期过度增强（APHE）和冲洗的时间被量化。通过多普勒超声检查肝动脉和门静脉血流参数的灌注指数（PI）和阻力指数（RI）。诊断金标准是 MRI/CT 或组织学。该研究包括 49 个肝脏病变 [23 个 TIPS（11 个 HCC），26 个无 TIPS（15 个 HCC）]。 26 人按照金标准诊断为 HCC。 CEUS 诊断有或没有 TIPS 的 HCC 的敏感性和特异性分别为 93.3% 和 100% vs. 90.9% 和 93.3%。与无 TIPS 的患者相比，TIPS 患者的 APHE 出现时间明显更早。 TIPS 显着强调 CEUS 中 HCC 的 APHE。 CEUS 对 TIPS 患者的 HCC 诊断具有良好的诊断性能。