Doppler Evaluation of Esophageal Variceal Bleeding in Patients with Cirrhosis
International Journal of Gastroenterology
Volume 1, Issue 1, December 2017, Pages: 5-8
Received: Feb. 1, 2017;
Accepted: Mar. 30, 2017;
Published: May 3, 2017
Views 2334 Downloads 150
Gyong-Hui Ri, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People’s Republic of Korea
Hak-Chol Ju, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People’s Republic of Korea
Gyang-Il Kim, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People’s Republic of Korea
Un-Gyong Ri, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People’s Republic of Korea
Un-Hua Ri, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People’s Republic of Korea
Follow on us
Esophageal Varices develops by the changes in portal hemodynamics. So, characterizing both the qualitative and quantitative changes in hemodynamics in the portal system is important in patients with Esophageal Variceal Bleeding caused by liver cirrhosis. We undertook this study to investigate the discriminant for estimate of esophageal variceal bleeding by significant Doppler parameters. The purpose of our study was to evaluate the significant Doppler parameters in patients with cirrhosis and to make a discriminant for estimate of esophageal variceal bleeding, and to predict the dangers of bleeding. Significant differences were found in main portal vein diameter(MPVD), MPV velocity max(MPV Vmax), blood flow rate of MPV and spleen vein, MPV congestion index(MPVCI), Right Portal Vein Vmax(RPVVmax), reflux of MPV, flat pattern of MPV between control group, none of varices group, EVB positive group and EVB negative group. MPVD, MPVVmax in EVB(+) group were significantly higher than in EVB(-) group(P<0.01). Any significant differences were not found in SV:MPV blood flow ratio between control goup and no varices group. Significant differences were found in MPVCI, RPVVmax between no varices group and EVB(-) group, EVB(+) group and EVB(+) group. MPVCI in EVB(+) group were higher than the EVB(-) group(p<0.05) and RPVVmax in EVB(+) group were lower than EVB(-) group. We had found the significant color and impulse Doppler parameters to evaluate the esophageal varices and predicted danger of esophageal variceal bleeding by discriminant. In the patient with portal hypertension caused by cirrhosis significant Doppler parameters for evaluation of esophageal varices were MPVD, MPVVmax, CI, SV/MPV, RPVVmax, reflux of MPV, flat pattern of EVB. We made discriminant by 7 parameters and predicted dangers of EVB. Reliability of discriminant was 90% and 91.2% respectively in EVB positive group, EVB negative group.
Esophageal Variceal Bleeding, Doppler Evaluation, Portal Hemodynamics
To cite this article
Doppler Evaluation of Esophageal Variceal Bleeding in Patients with Cirrhosis, International Journal of Gastroenterology.
Vol. 1, No. 1,
2017, pp. 5-8.
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CosarS. et al. Doppler and Gray―Scale Ultrasound Evaluation of Morphological and Hemodynamic Changes in Liver Vasculature in Alcoholic Patients, Eur―J―Radiol 54(3), 393~402, 2005.
Djenic S. S. et al.; Doppler Hemodynamic Study in Evaluation of Liver Metastases, Acta―Chir―Iugosl 54(2), 9~12, 2007.
Fabio Piscagliaet al.; Value of Splanchnic Doppler Ultrasound in the Diagnosis of Portal Hypertension, Ultrasound in Med. & Biol. 27(7), 893~899, 2001.
Hao. J. et al.; Hemodynamic Analysis of Esophageal Varices in Patients with Liver Cirrhosis using Color Doppler Ultrasound, World―J―Gastroenterol 11(29), 4560~4565, 2005.
Li X. et al.; A Randomized Controlled Study of Liqustrazine in Combination with Propranolol for Prevention of Recurrent Esophageal Varices Bleeding, Zhonghua―Gan―Zang―Bing―Za―Zhi 8(2), 99~101, 2000.
Li Z. X. et al.;Noninvasive Evaluation of Hepatic Fibrosis in Children with InFant Hepatitis Syndrome, World―J―Gastroenterol 12(44), 7155~7215, 2006.
Lopez Mendez E. et al.; Renal Hemodynamics and its Correlation with the Child―Pugh Stage in Cirrhotic Patients and Their Controls, Rev―Gastroenterol―Mex 71(3), 302~309, 2006.
Marineo G. et al.; Biophysics and Clinical Practice for Regenerative Processes in Cirrhosis of the Liver/of Liver Cirrhosis Assisted by Delta―S Entropy Variation Systems, Minerva―Gastroenterol―Dietol 52(4), 365~435, 2006.
Moon D. B. et al.; Application of Intraoperative Cine―Protogram to Detect Spontaneous Portosystemic Collaterals Missed by Intraoperative Doppler Exam in Adult Living Donor Liver Transplantation, Liver―Transpl 13(9), 1279~1363, 2007.
Orban Schiopu A. M. et al.; The effect of a Combined Treatment with Propranolol and Isosorbide―5―mononitrate on Doppler Ultrasound Parameters in Patients with Cirrhosis and Portal Hypertension, Rom―J―Gastroenterol 14(2), 123~130, 2005.
P. A. Mc. Cormick et al.;Improving Prognosis Following a First Variceal Haemorrhage Over Four Decades, Gut An International Journal of Gastroenterology and Hepatology 49(5), 5, 2001.
Panarace M. et al.;Transrectal Doppler Sonography for Evaluation of Uterine Blood Flow Throughout Pregnancy in 13 cows, Theriogenology 66(9), 2113~2122, 2006.
Peng Zhi Hai et al.;The application of prostaglandin E1 indirect portal vein angiography and color Doppler ultrasound in patients with post―devascularization portal hypertesion, Journal of Tongji medical university 15(3), 154~157, 1995.
R. Robles et al.; Surgery for Esophageal Varix Bleeding in Cirrhotic Patients During the Era of Liver Transplants, Transplantation Proceedings 31(6), 2386~2387, 1999.
Ramazan Kutlu et al.; Quantitative Doppler Evaluation of the Splenoportal Venous System in Various Stages of Cirrhosis, Journal of Clinical Ultrasound 30(9), 537~543, 2002.
Wood MM, Romine LE, Lee YK, et al. Spectral Doppler signature waveforms in ultrasonography: a review of normal and abnormal waveforms. Ultrasound Q 2010; 26:83.