This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sato, T. Articles by Akaike, J. Search for Related Content PubMed PubMed Citation Articles by Sato, T. Articles by Akaike, J.

Diagnosis of Gastric Varices and Evaluation of the Effectiveness of Treatment Using Transabdominal Color Doppler Ultrasonography

Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan.

Address correspondence to Takahiro Sato, MD, Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan., E-mail: taka.sato{at}ja-hokkaidoukouseiren.or.jp

Objective. The aim of this study was to evaluate the hemodynamics of gastric varices using transabdominal color Doppler ultrasonography (CDUS). Methods. Using CDUS, we evaluated 41 consecutive patients with gastric varices. We examined color flow images and measured the velocity of gastric variceal blood flow using fast Fourier transform analysis. In addition, we compared detection rates of gastric varices and their outflow vessels using CDUS and computed tomography (CT). Results. Gastric varices were detected with CDUS in 41 of 41 patients (100%), and outflow vessels were detected in 34 (82.9%). Of these, 32 were gastrorenal shunts (GRSs), and 2 were GRSs and subphrenic veins. The velocity of the large and coil-shaped varices (mean ± SD, 23.0 ± 5.8 cm/s; n = 13) was significantly higher than that of the enlarged and tortuous varices (14.1 ± 4.3 cm/s; n = 28; P < .001). With CT, gastric varices were detected in 41 of 41 patients (100%), and outflow vessels were detected in 38 (92.7%). Color Doppler ultrasonographic and CT findings were in complete agreement in 35 of 41 patients (85.4%). A total of 11 patients with a high risk of variceal rupture underwent balloon-occluded retrograde transvenous obliteration, and CDUS and CT findings after treatments were consistent. Conclusions. Transabdominal CDUS is a useful noninvasive modality for the diagnosis of gastric variceal hemodynamics and for evaluation of the therapeutic effects of gastric variceal treatment.

Key Words: color Doppler ultrasonography • computed tomography • gastric varices • portal hypertension

Abbreviations: B-RTO, balloon-occluded retrograde transvenous obliteration • CDUS, color Doppler ultrasonography • CT, computed tomography • ECDUS, endoscopic color Doppler ultrasonography • GRS, gastrorenal shunt • RC, red color • SV, subphrenic vein