The Usefulness of Endoscopic Color Doppler Ultrasonography in the Detection of Perforating Veins of Esophageal Varices

Abstract

We studied 118 patients using endoscopic color Doppler ultrasonography (ECDUS) to evaluate perforating veins of esophageal varices. The ECDUS was performed with a PENTAX FG‐32UA or FG‐36UX (7.5 MHz, convex type) and a HITACHI EUB 565 was used as a display device. We defined the perforating veins as communicating vessels between esophageal varices and paraesophageal veins. We evaluated the detection rate and the direction of blood flow in the perforating veins. Color flow images of perforating veins were obtained in 43 of the 118 (36.4%) patients. We classified the perforating veins into three types. Type 1 was characterized as an inflow type from paraesophageal veins to esophageal varices, Type 2 as an outflow type from esophageal varices to paraesophageal veins and Type 3 as a mixed type showing both inflow and outflow. Type 1 was recognized iri 37 (86.0%), Type 2 in four (9.3%) and Type 3 in two (4.7%) of 43 patients. We conclude that ECDUS is a useful modality for obtaining diagnostic color flow images of perforating veins, and for evaluating the blood flow direction in perforating veins. (Dig Endosc 1996; 8: 180‐183)

Perforating veins in recurrent esophageal varices evaluated by endoscopic color Doppler ultrasonography with a galactose-based contrast agent

“…There is little information in the literature on perforating veins. 5,[11][12][13][14] Color Doppler is based on the mean Doppler frequency shift and therefore is a measure of the directional component of the blood velocity moving through the sample volume. Power Doppler, on the other hand, is based on the integrated Doppler power spectrum, and the power in the Doppler signal is related to the number of red blood cells producing the Doppler shift.…”

“…We previously reported the usefulness of ECDUS in patients with esophago-gastric varices. 4,5 We have been able to obtain color flow images that graphically show esophageal varices, paraesophageal veins, and perforating veins in patients with esophageal varices.…”

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

“…We previously reported on the usefulness of ECDUS (convex-type scanning instruments with forward-oblique viewing) for evaluating the hemodynamics of esophagogastric varices. [1][2][3] We also previously found that the use of Levovist contrast can improve the diagnostic quality of convex-type ECDUS of esophageal variceal patients, yielding a much clearer picture of the hemodynamics. 4 In the present study, we report the usefulness of a new electronic radial ECDUS technique in evaluating the hemodynamics of esophageal varices by comparison with convex-type ECDUS.…”

Evaluation of the hemodynamics of rectal varices by endoscopic ultrasonography

“…5,6 On the other hand, we have reported the usefulness of endoscopic color Doppler ultrasonography (ECDUS) in patients with esophagogastric varices. [7][8][9] With ECDUS, color flow images in blood vessels can be obtained, and ECDUS allows for more detailed observation of the hemodynamics of esophagogastric varices than EUS. In this study, we examined the usefulness of ECDUS for evaluating hemodynamics in cases of rectal varices, and we compared blood flow velocities between rectal varices and esophageal varices.…”