Evaluation of arterial blood flow in esophageal varices via endoscopic color Doppler ultrasonography with a galactose-based contrast agent

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun; Kuwata, Yasuaki; Suga, Toshihiro
January 2005
Journal of Gastroenterology;2005, Vol. 40 Issue 1, p64
Academic Journal
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 he delineated in 37 patients in whom pulsatile waves were previously undiagnosed via pre-contrast ECI)IJS. 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.


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