ARDMS AB-Abdomen Exam - Topic 2 Question 12 Discussion

Actual exam question for ARDMS's AB-Abdomen exam

Question #: 12
Topic #: 2

Which sonographic finding is associated with normal postprocedural Doppler of a transjugular intrahepatic portosystemic shunt (TIPS)?

ATriphasic flow throughout stent

BLow-velocity flow throughout stent

CHepatofugal flow in the intrahepatic portal venous branches

DHepatopetal flow in the intrahepatic portal venous branches

Show Suggested Answer

Suggested Answer: D

After successful TIPS placement, the intrahepatic portal venous branches continue to exhibit hepatopetal (toward the liver) flow, while the stent itself shows continuous, relatively high-velocity monophasic flow. Hepatofugal flow in intrahepatic branches may indicate shunt dysfunction.

According to Zwiebel's Introduction to Vascular Ultrasound:

''Normal post-TIPS Doppler shows hepatopetal flow in the intrahepatic portal veins and continuous high-velocity flow within the stent.''

Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.

AIUM Practice Parameter for the Performance of Portal Venous Ultrasound, 2020.

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by Delmy at May 05, 2026, 07:38 PM

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Yuki

17 days ago

I feel like low-velocity flow might be a normal finding too, but it seems a bit counterintuitive.

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Alecia

22 days ago

I think I came across a practice question that mentioned triphasic flow being a good sign, but I can't recall if that applies specifically to TIPS.

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Chun

27 days ago

I remember studying that TIPS should ideally show hepatopetal flow in the portal branches, but I'm not entirely sure if that's the only indicator of normalcy.

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