Document Detail


Esophageal varices: evaluation with transesophageal MR imaging--initial experience.
MedLine Citation:
PMID:  16304087     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively use transesophageal magnetic resonance (MR) imaging to determine the morphologic and hemodynamic characteristics of esophageal varices. MATERIALS AND METHODS: The study was approved by the ethics committee. All patients gave written informed consent. Forty-two patients (29 men, 13 women; mean age, 58 years +/- 11 [standard deviation]) with esophageal varices that were recently demonstrated at endoscopy were included in the study. MR imaging was performed by using a receiver probe that was placed in the esophagus. Black-blood T2-weighted MR images were obtained with cardiac triggering and navigator gating of the right hemidiaphragm. On these images, the maximal diameter, minimal diameter, and surface area of the largest esophageal varix were measured. Periesophageal and paraesophageal varices were recorded. A hemodynamic examination was performed in the last 21 patients to undergo MR imaging, which was used to obtain measurements of flow velocity and rate before and after intravenous injection of 50 mug of octreotide or a placebo. A Kruskal-Wallis test was used to assess differences in the diameter and surface area of the varices according to endoscopic grade. Hemodynamic changes observed after octreotide or placebo injection were compared by using an analysis of variance and a 95% confidence interval. RESULTS: Periesophageal varices were observed in 36 patients, and paraesophageal varices were observed in 32 patients. The minimal diameter, maximal diameter, and surface area of the esophageal varices at MR imaging differed significantly according to endoscopic grade (P < .001). In the periesophageal varices, the velocity and flow changes caused by octreotide differed significantly from those caused by the placebo (P < .001). A decrease in velocity (mean velocity change, -2.766 cm.sec(-1)) and flow (mean flow change, -0.455 mL.sec(-1)) was noted after octreotide injection, but no significant change in velocity (mean velocity change, 0.252 cm.sec(-1)) or flow (mean flow change, 0.018 mL.sec(-1)) was noted after placebo injection. The surface area of the varices did not change significantly after octreotide (mean change, -0.771 mm2) or placebo (mean change, -0.015 mm2) injection. CONCLUSION: Transesophageal MR imaging is a feasible method to assess the morphologic and hemodynamic characteristics of esophageal varices before and after pharmacologic treatment.
Authors:
Laurence Annet; Frank Peeters; Yves Horsmans; Laurent Hermoye; Peter Starkel; Bernard E Van Beers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-11-22
Journal Detail:
Title:  Radiology     Volume:  238     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-23     Completed Date:  2006-01-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-75     Citation Subset:  AIM; IM    
Copyright Information:
RSNA, 2005.
Affiliation:
Diagnostic Radiology Unit, Center for Anatomic, Functional, and Molecular Imaging Research, Université Catholique de Louvain, St-Luc University Hospital, Avenue Hippocrate 10, B-1200 Brussels, Belgium. laurence.annet@rdgn.ucl.ac.be
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Esophageal and Gastric Varices / pathology*
Esophagoscopy
Feasibility Studies
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Prospective Studies
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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