Splanchnic vein measurements in patients with liver cirrhosis: a case-control study.

Abstract

The portal venous system was evaluated by real-time ultrasonography in 100 consecutive cirrhotic patients and 100 pair-matched controls to assess the sensitivity and specificity of ultrasound findings in detecting or excluding cirrhosis. The best discriminant findings were the expiration diameters of the superior mesenteric and the splenic vein and, chiefly. their sum corrected by body surfitce. In cirrhotics the calibers of the splanchnic veins significantly increase in relation to the extent of esophageal varices, but in individual patients this increase cannot predict the extent of varices, which are the main determinant of the bleeding risk. (Key words: liver, cirrhosis of; esophageal varices; portal hypertension; splanchnic vein measurements)Abdominal ultrasonography is being used more extensively in patients with liver cirrhosis. 1 -3 Previous studies have shown that in cirrhotic patients several sonographic findin gs may be observed, including alterations in splanchnic veins such as an increase in the caliber of splanchnic veins, and a diminished response of portal vessels to breathing. · -6The diagnostic usefulness of these findings, however, largely depends on the reliability of control data, which have never been obtained in a large series of matched healthy controls. -1-l'l Enlarged splanchnic vessels are possibly caused by portal hypertension, which is also responsible for the development of esophageal varices. Varices are well-known determinants of survival in these patients; large varices increase the risk of gastrointestinal hemorrhage.11 In a previous report, ultrasonography was proposed as a technique to identify patients with a high risk of bleeding.10 However, only the diameter of splanchnic vessels was considered and no detailed information was given regarding breathing.We report a detailed evaluation of the diagnostic

Ultrasound of diffuse liver disease and portal hypertension

“…This impression was confirmed by a paper that demonstrated that the diameters of the superior mesenteric vein and the splenic vein were statistically different in control subjects and in patients with cirrhosis [30]. The best discriminated findings were the expiration measurements [30].…”

Percutaneous treatment of symptomatic superior mesenteric vein stenosis using self-expanding nitinol stents

“…Retrospectively, we might have underestimated the diameter of the SMV in the CT scan and the placed stent (diameter 6 mm) may have been too small. It has been shown that the diameter of the SMV changes significantly under respiration (13,14). For the same reason we nowrecommend oversizing of self-expanding nitinol stents by 50 % for stenting of the SMV and a diameter of at least 10 mm should be used in accordance to the SMV stenting techniques of the other working groups(1-3).…”

Portal Blood Velocity and Flow in Aging Man

“…An increased caliber of the portal, splenic and mesenteric veins, particu larly if corrected for the body surface, is a sensitive and specific marker of portal hy pertension [19], Moriyasu et al [9] proposed that also the 'congestion index', i.e. the ratio between the cross-sectional area and the blood velocity in the portal vein, measured by pulsed echo-Doppler, might reflect the portal vein pressure.…”