Diagnosis of gastric varices and evaluation of the effectiveness of treatment using transabdominal color Doppler ultrasonography.
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.
Sato
Takahiro
T
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita Higashi, Chuo-ku, Japan. taka.sato@ja-hokkaidoukouseiren.or.jp
Yamazaki
Katsu
K
Akaike
Jun
J
D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*