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Use of the Ultrasonic Microprobe to Evaluate Gastric Varices –Comparison with Endoscopic Color Doppler Ultrasonography–
Author(s) -
SATO Takahiro,
YAMAZAKI Katsu,
TOYOTA Jouji,
KARINO Yoshiyasu,
OMURA Takumi,
SUGA Toshihiro
Publication year - 1997
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1997.tb00485.x
Subject(s) - medicine , varices , gastric varices , radiology , endoscope , varix , cirrhosis
This study was designed to evaluate the usefulness of the ultrasonic microprobe (UMP), as compared with endoscopic color Doppler ultrasonography (ECDUS), in detecting gastric varices in 18 patients. The gastric varices detected were categorized as follows: 14 F 2 type varices, four F 3 type. Among the 18 cases, four had cardiac varices, nine cardiofornical varices, and five fundic varices. UMP was easily performed visually by using an endoscope with a UM‐3R (20MHz) probe, inserted via the biopsy channel, and a display unit (Olympus EU‐M20). ECDUS was performed using a PENTAX FG‐32UA and a FG‐36UX, 7.5MHz, convex type. The display monitor was a HITACHI EUB 565. We were able to clearly delineate the vessel images of gastric varices in all 18 patients using UMP. Although the overall features of the peri‐gastric collateral veins could not be discerned with UMP, the color flow images of gastric varices and peri‐gastric collateral veins were clearly visualized in all 18 patients using ECDUS. It was thus possible to determine blood flow direction using ECDUS. We found the use of UMP to be advantageous in terms of the ease of operation and the excellent view provided of gastric varices. The fact that, due to limited penetration, UMP inadequately delineates the peri‐gastric collateral veins was determined to be a major drawback. Therefore, we recommend ECDUS for evaluating overall hemodynamics. It was, however, technically difficult to scan the fundal region because of the characteristics of the ECDUS instrument. Thus, we conclude that detailed evaluation of gastric varix hemodynamics is most successfully accomplished by using UMP in conjunction with ECDUS.