Document Detail


64-row multidetector computed tomography portal venography of gastric variceal collateral circulation.
MedLine Citation:
PMID:  20180241     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To study characteristics of collateral circulation of gastric varices (GVs) with 64-row multidetector computer tomography portal venography (MDCTPV). METHODS: 64-row MDCTPV with a slice thickness of 0.625 mm and a scanning field from 2 cm above the tracheal bifurcation to the lower edge of the kidney was performed in 86 patients with GVS diagnosed by endoscopy. The computed tomography protocol included unenhanced, arterial and portal vein phases. The MDCTPV was performed on an AW4.3 workstation. GVs were classified into three types according to Sarin's Classification. The afferent and efferent veins of each type of GV were observed. RESULTS: The afferent venous drainage originated mostly from the left gastric vein alone (LGV) (28/86, 32.59%), or the LGV more than the posterior gastric vein/short gastric vein [LGV > posterior gastric vein/short gastric vein (PGV/SGV)] (22/86, 25.58%), as seen by MDCTPV. The most common efferent venous drainage was via the azygos vein to the superior vena cava (53/86, 61.63%), or via the gastric/splenorenal shunt (37/86, 43.02%) or inferior phrenic vein (8/86, 9.30%) to the inferior vena cava. In patients with gastroesophageal varices type 1, the afferent venous drainage of GV mainly originated from the LGV or LGV > PGV/SGV (43/48, 89.58%), and the efferent venous drainage was mainly via the azygos vein to the super vena cava (43/48, 89.58%), as well as via the gastric/splenorenal shunt (8/48, 16.67%) or inferior phrenic vein (3/48, 6.25%) to the inferior vena cava. In patients with gastroesophageal varices type 2, the afferent venous drainage of the GV mostly came from the PGV/SGV more than the LGV (PGV/SGV > LGV) (8/16, 50%), and the efferent venous drainage was via the azygos vein (10/16, 62.50%) and gastric/splenorenal shunt (9/16, 56.25%). In patients with isolated gastric varices, the main afferent venous drainage was via the PGV/SGV alone (16/22, 72.73%), and the efferent venous drainage was mainly via the gastric/splenorenal shunt (20/22, 90.91%), as well as the inferior phrenic vein (3/23) to the inferior vena cava. CONCLUSION: MDCTPV can clearly display the afferent and efferent veins of all types of GV, and it could provide useful reference information for the clinical management of GV bleeding.
Authors:
Li-Qin Zhao; Wen He; Ming Ji; Peng Liu; Peng Li
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  16     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-24     Completed Date:  2010-05-03     Revised Date:  2010-09-30    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1003-7     Citation Subset:  IM    
Affiliation:
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Collateral Circulation*
Esophageal and Gastric Varices / diagnosis,  pathology*,  radiography*
Female
Humans
Male
Middle Aged
Phlebography* / instrumentation,  methods
Tomography, X-Ray Computed* / instrumentation,  methods
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