Azygos blood flow in cirrhosis: measurement with MR imaging and correlation with variceal hemorrhage.
OBJECTIVE
To evaluate magnetic resonance (MR) measurement of azygos blood flow (ABF) in assessment of risk of variceal hemorrhage in cirrhosis.


METHODS
ABF in 50 patients with cirrhosis and 20 healthy control subjects was evaluated with phase-contrast cine MR imaging at the transaxial subcarinal plane. Group 1 included nine patients with cervical-drainage varices draining into brachiocephalic vein; group 2 included 41 patients with varices draining into azygos vein and was subdivided as group 2A, 15 patients with variceal hemorrhage, and group 2B, 26 without variceal hemorrhage.


RESULTS
Azygos flow rate and velocity were increased in patients compared with that in control subjects. ABF in group 2A was faster than that in group 2B (cutoff, 15 cm/sec; sensitivity, 80%; specificity, 89%). Group 1 had ABF close to that of group 2B, but variceal hemorrhage occurred in seven of nine patients in group 1 versus 15 of 41 patients in group 2 (78% vs 37%; P = .029).


CONCLUSIONS
Patients with cirrhosis with cervical-drainage varices or ABF greater than 15 cm/sec may have higher risk for variceal hemorrhage.
Wu
M T
MT
Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan, Republic of China.
Pan
H B
HB
Chen
C
C
Chang
J M
JM
Lo
G H
GH
Wu
S S
SS
Yeung
H N
HN
Yang
C F
CF
D001401:Azygos Vein / Q000502:physiology*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D012039:Regional Blood Flow; D012307:Risk Factors; D012680:Sensitivity and Specificity