Portal duplex sonography in liver cirrhosis. A useful supplement to endoscopic evaluation of bleeding risk of esophageal varices?
BACKGROUND
In a prospective study we investigated whether the endoscopic assessment of the bleeding risk of esophageal varices could be supported by portal duplex sonography.


METHODS
Over the time span of 2.5 years (range, 13 +/- 5 months) we observed 41 patients with liver cirrhosis. During that time 17 patients had acute esophageal variceal hemorrhage and constituted the bleeding group, and the remaining 24 patients without a hemorrhage constituted the non-bleeding group.


RESULTS
Within the bleeding group the mean portal blood flow velocity (Vm) was 0.093 +/- 0.033 m/sec, and the mean flow volume (Fm) was 0.371 +/- 0.173 l/min. Both results were significantly lower than the corresponding results of the nonbleeding group (p < 0.017; p < 0.05). By assuming cut-offs for Vm of 0.12 m/sec and for Fm of 0.420 l/min, we obtained a diagnostic sensitivity for hemorrhage of 0.88 and 0.65.


CONCLUSIONS
Our results show that portal duplex sonography may improve the evaluation of endoscopically ascertained bleeding risk of esophageal varices.
Körner
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Klinikum für Innere Medizin II, Klinikum Suhl, Germany.
D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology*; D004945:Esophagoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*