Fenghua Li, Presenter: Nothing to Disclose

Jianguo Xia, Abstract Co-Author: Nothing to Disclose

Hongli Li, Abstract Co-Author: Nothing to Disclose

Hua Fang, Abstract Co-Author: Nothing to Disclose

To study the portal hemodynamics and their relationship with the size of esophageal varices and to evaluate whether some Doppler-US parameters might predict variceal bleeding in patients with liver cirrhosis and portal hypertension.

One hundred and twenty cirrhotic patients with esophageal varices and 30 healthy controls were enrolled in the prospective study. All patients underwent endoscopy before or after color Doppler-ultrasonic examination. Measurements of diameter, flow direction and flow velocity in the LGV and PV were done using US. Then after 30 minutes after oral administration of glucose, changes of the diameter, flow velocity and direction in the PV and LGV were examined in 60 patients and 15 healthy controls.

The PV and LGV were detected successfully in 115 (96%) and 105 (88%) of 120 cirrhotic patients, respectively, and in 27 (90%) and 21 (70%) of 30 healthy controls, respectively. Among the 120 cirrhotic patients, 37 had F1, 59 had F2, and 24 had F3 grade varices. In the cirrhotic group, no difference in portal flow velocity and diameter were observed between patients with or without esophageal variceal bleeding (EVB). However, the diameter and blood flow velocity of the LGV were significantly higher for EVB (＋) group compared with EVB (－) group (P＜0.01). As the size of varices enlarged, hepatofugal flow velocity of LGV increased (P<0.01). Variceal bleeding was more frequent in patients with a hepatofugal flow velocity＞15 cm/s (61.5%). No correlation was observed between the portal blood flow velocity and esophageal variceal bleeding. Changes in diameter of the PV and LGV were not significant and flow direction changed to hepatofugal in 9 of 16 patients with hepatopetal and to and fro blood flow after ingestion of glucose. In 44 patients with hepatofugal blood flow in the LGV, a significant increase in hepatofugal flow velocity was observed . Patients who responded excessively to food ingestion might have a high risk for bleeding.

Hemodynamics of the LGV appears to be superior to those of the PV in predicting variceal bleeding in patients with liver cirrhosis and portal hypertension.

Li, F, Xia, J, Li, H, Fang, H, Hemodynamic Analysis of Esophageal Varices in Patients with Liver Cirrhosis Using Color Doppler Ultrasound.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4414433.html