Document Detail


Evaluation of arterial blood flow in esophageal varices via endoscopic color Doppler ultrasonography with a galactose-based contrast agent.
MedLine Citation:
PMID:  15692791     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined the usefulness of endoscopic color Doppler ultrasonography, using Levovist in evaluating the arterial blood flow, in patients with esophageal varices. METHODS: The study involved 110 patients with esophageal varices who were examined using endoscopic color Doppler ultrasonography (ECDUS). We compared vessel images detected by pre-contrast ECDUS with those detected by enhanced ECDUS. We evaluated the detection rate of the pulsatile wave, and measured systolic velocity and end-diastolic velocity. We calculated the resistance index (RI), which demonstrates the resistance of peripheral vessels in arterial flow. RESULTS: Color flow images of the pulsatile wave were obtained by pre-contrast ECDUS in 3 (2.7%) of the 110 patients. Color flow images of the pulsatile waves were obtained in 40 (36.4%) of the 110 patients by enhanced ECDUS using Levovist. That is, by using Levovist, a pulsatile wave could be delineated in 37 patients in whom pulsatile waves were previously undiagnosed via pre-contrast ECDUS. Color flow images of the pulsatile waves were detected in 37 (37.7%) of the 98 F2 varices and in 3 (25.0%) of the 12 F3 varices. Color flow images of the pulsatile wave were detected in 35 (40.2%) of the 87 red color (RC)(+) varices, and in 5 (21.7%) of the 23 RC(++) or RC (+++) varices. Next, we calculated the RI of the pulsatile wave, obtained by enhanced ECDUS using Levovist, in 40 patients. The RI ranged from 0.49 to 0.83 (mean, 0.67 +/- 0.09); there were nine patients with RIs of less than 0.60, and all 9 of these patients had both F2 and RC(+) type varices (100%). CONCLUSIONS: Levovist contrast in ECDUS examinations suggests that arterial flow is involved in the formation of esophageal varices.
Authors:
Takahiro Sato; Katsu Yamazaki; Jouji Toyota; Yoshiyasu Karino; Takumi Ohmura; Jun Akaike; Yasuaki Kuwata; Toshihiro Suga
Publication Detail:
Type:  Case Reports; Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of gastroenterology     Volume:  40     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-04     Completed Date:  2005-12-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  64-9     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Flow Velocity / physiology
Blood Pressure / physiology
Collateral Circulation / physiology
Contrast Media / administration & dosage*
Diastole / physiology
Endosonography*
Esophageal and Gastric Varices / physiopathology*,  ultrasonography*
Esophagus / blood supply,  ultrasonography
Female
Galactose / administration & dosage*,  diagnostic use*
Humans
Japan
Liver Cirrhosis / physiopathology,  ultrasonography
Male
Middle Aged
Pulsatile Flow / physiology
Regional Blood Flow / physiology
Systole / physiology
Ultrasonography, Doppler, Color*
Chemical
Reg. No./Substance:
0/Contrast Media; 26566-61-0/Galactose

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