title: Echo-endoscopic analysis of variceal hemodynamics in patient with isolated gastric varices.
abstract: BACKGROUND
  It is considered that gastric varices (GVs) which have the large form in endoscopic view should be treated because they are regarded as having high blood flow volume and the risky varices of hemorrhage. However, there is no data of the correlation among the endoscopic view, diameter of GV, and blood flow volume in GV. The aim of this study was to investigate whether GV diameter correlates to blood flow volume or not. In addition, the correlation between the endoscopic findings of GVs, patient status, and blood flow volume was assessed.
  
  
  METHODS
  In this study, 24 patients were enrolled. Variceal form and its location were observed using flexible GI endoscopes. Assessment of variceal form and location was according to Japanese society of portal hypertension. Then, the GV diameter (the maximum short axis), the GV flow velocity, and the GV flow volume were measured by echo-endoscope with curved linear array or with electronic radial array.
  
  
  RESULTS
  Nineteen of 24 enrolled patients were analyzed. There was strong correlation between the GV diameter and the GV flow volume (rs = 0.85, P < 0.01). No significant difference in the GV diameter and the GV flow volume was found between each location. However, there was no significant difference in the GV diameter between each variceal form. In addition, no significant difference was found among Child-Pugh classifications, and in cases associated with or without hepatocelluer carcinoma.
  
  
  CONCLUSIONS
  Strong correlation was found between GV diameter and flow volume of GV, regardless of the location. However, since there was no significant difference in the GV diameter between each variceal form in endoscopic view, measuring GV diameter is important to understand its hemodynamics for further treatment.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: HIdemichi
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.affiliation: Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Shibukawa
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
keywords: Endoscopic ultrasound; flow volume; gastric varices hemodynamics