title: The application of transabdominal 3D ultrasound for the diagnosis of gastric varices: a preliminary study.
abstract: OBJECTIVE
  The aim of this study was to determine the feasibility of using transabdominal three-dimensional (3D) colour Doppler ultrasound as a non-invasive tool to demonstrate and quantify gastric varices.
  
  
  METHODS
  A phantom study compared the 3D water flow volume data in a hose with the actual volume inside the hose at three different flow velocities. The prospective clinical study examined the reliability and reproducibility of 3D volume data for gastric varices (mild 28, moderate 26, large 8) in 62 patients. The 3D images were acquired using the colour Doppler with both convex and micro-convex probes.
  
  
  RESULTS
  The phantom study showed a 12.4-17.6% difference between the 3D data and the actual volume with no difference between the two types of probes or three velocities. The detectability of gastric varices was identical between the two probes (54/62, 87.1%). However, the scanning efficiency was significantly greater for the micro-convex probe (66.9 ± 14.1%) than the convex probe (57.3 ± 14%, p=0.012). Body mass index was the only factor that had a significant relationship with the detectability of varices. The mean volume (mL) of the 3D signal was 0.82 ± 0.74 for mild varices, 5.48 ± 3.84 for moderate varices, and 10.63 ± 6.67 for large varices with significant differences between different grades. The intra-/inter-rater reliability was excellent.
  
  
  CONCLUSIONS
  The method of 3D colour Doppler ultrasound is reliable and reproducible in the quantitative assessment of vascular volume and is applicable for grading gastric varices. This study may offer a practical usefulness for 3D ultrasonography as an alternative to endoscopy.
authors.affiliation: Department of Gastroenterology and Hepatology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba 260-8670, Japan. maru-cib@umin.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kamezaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kondo
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sekimoto
authors.forename: Taro
authors.initials: T
authors.lastname: Shimada
authors.forename: Masanori
authors.initials: M
authors.lastname: Takahashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
keywords: Gastric varices; Portal hypertension; Three-dimensional image; Ultrasound