Usefulness of electronic radial endoscopic color Doppler ultrasonography in esophageal varices: comparison with convex type

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun; Kuwata, Yasuaki; Suga, Toshihiro
January 2006
Journal of Gastroenterology;Jan2006, Vol. 41 Issue 1, p28
Academic Journal
Background. Endoscopic color Doppler ultrasonography (ECDUS) is a method for detecting color flow images in blood vessels. We previously reported on the usefulness of ECDUS (convex-type scanning instruments with forward—oblique viewing) for evaluating the hemodynamics of esophageal varices. In the present study, we report the usefulness of new electronic radial ECDUS in cases of esophageal varices by comparison with convex-type ECDUS. Methods. Twenty-six patients with esophageal varices were identified and studied. The underlying pathologies of portal hypertension included liver cirrhosis (15 patients) and cirrhosis associated with hepatocellular carcinoma (11 patients). Endoscopic findings of esophageal varices were as follows: Cb, F3, and Ls varices in four patients; Cb, F2, and Lm varices in 21 patients; and Cb, Lm, and F1 varices in one patient. RC1 was observed in the esophagus in 14 of the 26 patients. RC2 was noted in 11 cases, and RC0 was seen in one patient. ECDUS was performed using a Pentax EG-3630UR (forward view) with a distal tip diameter of 12 mm. The instrument (electronic radial array) has a curved array scanning transducer with variable frequency (5.0, 7.5, 10.0MHz). A Hitachi EUB 6500,8500 was used for the display, providing 270° images. We monitored the color flow images of esophageal varices, paraesophageal veins, palisade veins, perforating veins, and pulsatile waves using this technique. As a control, 110 patients were examined by convex-type ECDUS. Results. (1) Color flow images of esophageal varices and paraesophageal veins were obtained in 26 of the 26 patients, whereas color flow images of perforating veins were obtained in 18 of the 26 patients (69.2%). Color flow images of palisade veins were obtained in 12 of the 26 patients (46.2%). (2) Color flow images of pulsatile waves were obtained in 10 of the 26 patients (38.5%). Color flow images of pulsatile waves were detected in zero (0%) of the 4 F3 varices, in nine (42.9%) of the 21 F2 varices, and in the 1 (100%) case of F1 varices. Also, color flow images of pulsatile waves were detected in seven (50.0%) of the 14 RC1 varices, in two (18.2%) of the 11 RC2 varices, and in the 1 (100%) case of RC0 varices. (3) As a control, 110 patients were examined by convex-type ECDUS. Color flow images of esophageal varices and paraesophageal veins were obtained in 110 of the 110 patients, whereas color flow images of perforating veins were obtained in 74 of 110 (67.3%) with convex-type ECDUS. The detection rate of palisade veins with electronic radial ECDUS (12 of the 26 patients, 46.2%) was significantly higher than with convex-type ECDUS (28 of the 110 patients, 25.5%) (P < 0.05). The detection rate of pulsatile waves with electronic radial ECDUS (10 of the 26 cases, 38.5%) was significantly higher than with convex-type ECDUS (3 of the 110 cases, 2.7%) (P < 0.0001). Conclusions. Electronic radial ECDUS provides clear color flow images of blood vessels in esophageal varices with the additional advantages of forward-view optics and extended 270° views. Electronic radial ECDUS was superior to convex-type ECDUS in detecting palisade veins and pulsatile waves.


Related Articles

  • Endoscopic Color Doppler Ultrasonography for Esophagogastric Varices. Takahiro Sato; Katsu Yamazaki // Diagnostic & Therapeutic Endoscopy;2012, p1 

    Esophagogastric varices are considered to be the most common complication in patients with portal hypertension. Endoscopic ultrasonography not only visualizes the surface of the varices but also provides detailed information about their internal structure. The direction of blood flow can be...

  • Doppler Assessment of Hepatic Venous Waves for Predicting Large Varices in Cirrhotic Patients. Joseph, Thomas; Madhavan, Mukunda; Devadas, Krishnadas; Ramakrishnannair, Vinayakumar K. // Saudi Journal of Gastroenterology;Jan2011, Vol. 17 Issue 1, p36 

    Background/Aim: Color Doppler examination of changes in hepatic venous waveforms is being evaluated as a means of prediction of severity of portal hypertension and presence of esophageal varices. Normal hepatic venous waveform shows a triphasic pattern. In cirrhosis, this pattern changes to a...

  • EXTRAHEPATIC PORTAL VEIN OBSTRUCTION IN CHILDREN: A CASE REPORT. Hermina, Girbovan Anamaria; Salomea-Ruth, Halmágyi; Hamida, Al Hussein; Mădălina, Grigore; Claudia, Sîrbe; Alina, Grama; Pop, Tudor L. // Acta Medica Marisiensis;2019 Supplement, Vol. 65, p112 

    Background: Extrahepatic portal vein obstruction (EHPVO), although rare in children, is one of the most important causes of noncirrhotic portal hypertension (NCPH) among children. The incidence of EHPVO is estimated to be 0,72/million. The initial clinical manifestation can be represented by...

  • Incidence of the appearance of the red color sign on esophageal varices and its predictive factors: long-term observations of 359 patients with cirrhosis. Murashima, Naoya; Ikeda, Kenji; Kobayashi, Masahiro; Saitoh, Satoshi; Chayama, Kazuaki; Tsubota, Akihito; Suzuki, Yoshiyuki; Suzuki, Fumitaka; Arase, Yasuji; Kumada, Hiromitsu // Journal of Gastroenterology;2001, Vol. 36 Issue 6, p368 

    Purpose. The red color sign observed by endoscopic examination is a reliable predictive factor for variceal bleeding. The aim of this study was to calculate the incidence of the appearance of the red color sign and to evaluate its predictive factors. Methods. Endoscopic examination was...

  • Severe bleeding from esophageal varices resistant to endoscopic treatment in a non cirrhotic patient with portal hypertension. Roberto Caronna; Mario Bezzi; Monica Schiratti; Maurizio Cardi; Giampaolo Prezioso; Michele Benedetti; Federica Papini; Simona Mangioni; Gabriele Martino; Piero Chirletti // World Journal of Emergency Surgery;2008, Vol. 3, Special section p1 

    A non cirrhotic patient with esophageal varices and portal vein thrombosis had recurrent variceal bleeding unsuccessfully controlled by endoscopy and esophageal transection. Emergency transhepatic portography confirmed the thrombosed right branch of the portal vein, while the left branch...

  • Radiofrequency Ablation Plus Devascularization Is the Preferred Treatment of Hepatocellular Carcinoma with Esophageal Varices. Zhang, Ke; Jiang, Li; Jia, Zhe; Zhang, Yao; He, Rong; Ding, Zhenhao; Mu, Yi // Digestive Diseases & Sciences;May2015, Vol. 60 Issue 5, p1490 

    Background: Most hepatocellular carcinomas (HCCs) are associated with cirrhosis. Portal hypertension (PHT) and esophageal variceal bleeding (EVB) can limit the patient's treatment options. Surgical therapy in such patients is challenging. We performed devascularization plus liver resection or...

  • Neinvazivna procena postojanja i veličine variksa jednjaka kod bolesnika obolelih od ciroze jetre pomoću indeksa desni lobus jetre/serumska koncentracija albumina. Alempijević, Tamara; Bulat, Vladislava; Kovačević, Nada; Ješić, Rada; Đuranović, Srđan; Tomić, Dragan; Krstić, Miodrag // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Jul2007, Vol. 64 Issue 7, p453 

    Background/Aim. Liver cirrhosis is a chronic, progressive disease and it is usually accompanied by portal hypertension. The development of oesophageal varices (OV) is one of the major complications of portal hypertension. Cirrhotic patients should be screened for the presence of OV when portal...

  • A not so bitter pill to swallow.  // Gut;May2006, Vol. 55 Issue 5, p732 

    An abstract of the articles about endoscopy is presented, including "The Accuracy of PillCam ESO Capsule Endoscopy Versus Conventional Upper Endoscopy for the Diagnosis of Esophageal Varices: A Prospective Three-Center Pilot Study," and Esophageal Capsule Endoscopy Versus...

  • Endosonografia w diagnostyce żylaków żoÅ‚Ä…dka. Wiechowska-Kozłowska, Anna; Bialek, Andrzej; Milkiewicz, Piotr // Gastroenterologia Polska / Gastroenterology;2008, Vol. 15 Issue 2, p129 

    Endosonography (EUS), which combines routine endoscopy and ultrasound examination, has been rarely used in the routine diagnostic of portal hypertension. Gastroduodenoscopy is still the method of choice for the diagnosis of varices but it only allows for analysis of superficial varices....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics