[Contrast-enhanced MR angiography for differentiation between perigastric and submucosal gastric fundal varices].
OBJECTIVE
To evaluate contrast-enhanced MR angiography for the distinction between perigastric and submucosal fundal varices.


METHODS
Nineteen consecutive patients with clinically suspected fundal varices underwent contrast-enhanced MR angiography and endoscopic ultrasound (EUS) within one week. Diagnostic confidence for the detection of perigastric and submucosal fundal varices was compared between MR angiography (two radiologists) and EUS (one gastroenterologist), and the agreement of size and location was evaluated.


RESULTS
Both MR angiography and EUS detected perigastric varices in all 19 patients and submucosal fundal varices in 14 of the 19 patients. The interobserver reliability of MR angiography was good for measuring the variceal diameter (kappa = 0.76) and excellent for localizing the varices (kappa = 1.0). EUS and MR angiography agreed in 12 of 14 patients (86 %) in determining variceal diameter and location.


CONCLUSIONS
Contrast-enhanced MR angiography is comparable to endoscopic ultrasound in the detection and characterization of gastric fundal varices.
Willmann
J K
JK
Institut für Diagnostische Radiologie, Universitätsspital Zürich, Switzerland.
Bauerfeind
P
P
Boehm
T
T
Lutz
A M
AM
Göpfert
K
K
Marincek
B
B
Weishaupt
D
D
D000328:Adult; D000368:Aged; D003287:Contrast Media; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000175:diagnosis*; D005260:Female; D005583:Fourier Analysis; D005748:Gastric Fundus / Q000098:blood supply / Q000473:pathology; D005753:Gastric Mucosa / Q000098:blood supply / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006571:Heterocyclic Compounds; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000209:etiology; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D012680:Sensitivity and Specificity
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate