Colour flow mapping of oesophagogastric varices and vessels in and around the liver with trans-oesophageal real-time two-dimensional doppler ultrasound

Sukigara, Minoru; Komazaki, Toshiro; Yamazaki, Tatsuo; Anzai, Haruyuki; Koyama, Isamu; Omoto, Ryozo

doi:10.1016/s0009-9260(87)80130-7

Cited by 17 publications

(3 citation statements)

References 19 publications

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“…In addition, the electronic radial endoscope could use the Doppler function, of which usefulness has already been reported not only in EUS‐FNA but also in the diagnosis of esophagogastric varices 14–17 and blood vessel invasion of bilio‐pancreatic tumors, 18 although it is not easy to obtain good images because of the respiratory and aortic movements. However, we expect the new possibility of EUS image diagnosis using the Doppler function of the electronic radial endoscope.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of the Newly Developed Electronic Radial Ultrasound Endoscope

Ogawa

Yasuda

Cho

et al. 2005

Digestive Endoscopy

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Background: Endoscopic ultrasonography (EUS) is widely accepted as a diagnostic tool for bilio-pancreatic and gastrointestinal tract diseases. Recently, an ultrasound endoscope with an electronic radial scan transducer has been developed. To evaluate the clinical usefulness of this system, its image quality, advantages and disadvantages were evaluated. Materials and methods: Ultrasound endoscope with electronic radial scan transducer and its monitor unit were used. The direction of the imaging plane was similar to that of the mechanical radial models. Color Doppler function and tissue harmonic imaging were feasible by this system. To evaluate this endoscope, we investigated the image quality and distance resolution by in-vitro study using thin papers, and 50 patients were examined by this system. Results: Comparison with the mechanical radial endoscope GF-UM2000 revealed that the image quality was almost equivalent. However, the ultrasound penetration of the electronic radial scanner was better and more satisfactory with less echoic reduction. In addition, the blood-flow signal could be obtained by using the color Doppler function. In contrast, the diameter of the new endoscope was bigger than the advanced mechanical radial models, the monitor unit was bigger than that of the mechanical radial system, and the operation of this unit was complicated. Conclusion: A prototype of the ultrasound endoscope with electronic radial scan showed satisfactory results regarding the image quality, ultrasound penetration, and clinical diagnosis. The blood flow could be investigated by using the color Doppler function, which is useful to diagnose lesions and detect involvement of the blood vessels in cancers.

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Section: Discussionmentioning

confidence: 99%

Clinical Use of the Newly Developed Electronic Radial Ultrasound Endoscope

Ogawa

Yasuda

Cho

et al. 2005

Digestive Endoscopy

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“…This was explained by the presence and demonstration of func− tioning perforating veins joining esophageal varices to perieso− phageal veins, particularly at the lower end of the esophagus. Perforating veins were also detected and described by transeso− phageal real−time two−dimensional Doppler ultrasonography by Sukigara et al [26]. A subsequent study has further defined esophageal perforating veins as veins connecting esophageal varices with perivariceal or paravariceal collateral veins [21].…”

Section: Eus and Study Of Esophageal And Gastric Perforatorsmentioning

confidence: 93%

EUS for portal hypertension: a comprehensive and critical appraisal of clinical and experimental indications

Elsaadany¹,

Jalil²,

Irisawa³

et al. 2008

Endoscopy

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Endoscopic ultrasonography (EUS) has significantly improved our understanding of the complex vascular structural changes that occur in portal hypertension and their clinical and prognostic significance. EUS in combination with color Doppler technique enables us to study the hemodynamic changes in the portal venous system noninvasively, and to determine objectively the effect of different pharmacological agents on portal hypertension. EUS has also found some role in the treatment and follow up of esophageal and gastric varices. It may play a clinical role in the diagnosis of gastric, duodenal, and rectal varices. Recently reported EUS-based devices that measure variceal wall tension and intravariceal pressure noninvasively could have an impact on the identification of patients at high risk of variceal bleeding with the aim of initiating prophylactic treatment, and in the assessment of patients' responses to drug therapy of portal hypertension. EUS is occasionally very helpful in the clinical management of portal hypertension. It is an interesting and important research tool for many experimental indications that are not routinely applied in clinical practice at this time.

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“…2). Blood may also travel in a retrograde manner from the superior mesenteric vein into the systemic circulation via the splenic vein and splenorenal collaterals, resulting in splenic vein flow reversal (12).…”

Section: Portal Veinmentioning

confidence: 99%

The Value of Doppler Ultrasound in Cirrhosis and Portal Hypertension

Kok¹

1999

Scandinavian Journal of Gastroenterology

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Kok Th, van der Jagt EJ, Haagsma EB, Bijleveld CMA, Jansen PLM, Boeve WJ. The value of Doppler ultrasound in cirrhosis and portal hypertension. Scand J Gasteroenterol 1999;34 Suppl 230:82-8. Background: Cirrhosis and portal hypertension affect the flow profile of the liver vasculature. In these conditions Doppler ultrasound can provide important information on the hemodynamics of the portal venous system, the hepatic artery and the hepatic veins. Methods: The value of Doppler ultrasound in the assessment of the patient with cirrhosis and portal hypertension was determined by reviewing the literature. Results: Portal venous blood flow becomes reversed with advanced portal hypertension. Reversed flow is also demonstrated in patients with veno-occlusive disease and portosystemic shunts. Despite general agreement that portal flow velocity is decreased in cirrhotic patients, the absolute values of portal flow velocity in both healthy subjects and cirrhotic patients vary considerably. Errors in Doppler measurements, observer variability and collateral pathways contribute to these variations. Furthermore, portal blood flow is influenced by numerous factors such as changes in the body position, phase of respiration, timing of meals, exercise and cardiac output. Finally, portal flow may be unaltered due to a combination of high inflow from the splanchnic organs and increased resistance within the liver. High resistive index of the hepatic artery is seen in patients with end-stage liver disease, particularly in children with severe cirrhosis secondary to biliary atresia. However, hepatic artery flow remains normal in most patients. Abnormal hepatic vein flow profiles are seen in patients with cirrhosis, but dampening or flattening of the flow profile has a multifactorial origin (Budd-Chiari, metastases, ascites) and can be observed in healthy subjects. Conclusions: Although many factors may affect the accuracy of volume flow and velocity measurements and the flow profile of the liver vasculature may change in different situations, Doppler ultrasound is useful in the assessment of the patient with cirrhosis and portal hypertension.

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Colour flow mapping of oesophagogastric varices and vessels in and around the liver with trans-oesophageal real-time two-dimensional doppler ultrasound

Cited by 17 publications

References 19 publications

Clinical Use of the Newly Developed Electronic Radial Ultrasound Endoscope

Clinical Use of the Newly Developed Electronic Radial Ultrasound Endoscope

EUS for portal hypertension: a comprehensive and critical appraisal of clinical and experimental indications

The Value of Doppler Ultrasound in Cirrhosis and Portal Hypertension

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