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Obliteration of gastric varices improves the arrival time of ultrasound contrast agents in hepatic artery and vein
Author(s) -
Furuichi Yoshihiro,
Moriyasu Fuminori,
Sugimoto Katsutoshi,
Taira Junichi,
Sano Takatomo,
Miyata Yuki,
Sofuni Atsushi,
Itoi Takao,
Nakamura Ikuo,
Imai Yasuharu
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12234
Subject(s) - medicine , cirrhosis , indocyanine green , ultrasound , vein , gastric varices , artery , varices , contrast enhanced ultrasound , portal hypertension , gastroenterology , radiology , nuclear medicine , surgery
Background and Aim Liver cirrhosis ( LC ) is accompanied by hepatic arterializations, intrahepatic shunts, and hyperdynamic circulations. These changes shorten the arrival time ( AT ) of ultrasound contrast agents to the hepatic vein ( HV ). Whether treatment of gastric fundal varices ( GV s) by balloon‐occluded transvenous obliteration ( B ‐ RTO ) improves the AT in LC patients was prospectively investigated. Methods A total of 32 LC patients with GV s and 10 normal controls ( NC s) were enrolled. This study was approved by the clinical research ethics committee. Images of hepatic artery ( HA ), portal vein ( PV ), and HV were monitored after an injection of a contrast agent using quantification software. The AT before and after B ‐ RTO in LC patients and that in NC s were compared. Results All GV s were treated effectively, and indocyanine green retention rate was improved ( P < 0.0001). The mean values of the HA , PV , and HV AT s in the NC s were 21.9 ± 3.3, 28.2 ± 2.0, and 40.5 ± 2.1 s, respectively. Those in LC patients were 17.4 ± 4.4, 21.9 ± 5.6, and 26.3 ± 6.7, respectively, which were shorter than those in NC s ( P < 0.01, P < 0.002, P < 0.0001, respectively). However, these AT s were significantly prolonged 1 week after B ‐ RTO , with mean values of 18.7 ± 4.8, 23.8 ± 6.0, and 30.0 ± 7.2 s ( P = 0.043, P < 0.01, P < 0.001). Conclusion Obliteration of GV s shifted the AT in LC patients to the normalization, raising the possibility of improvement of arterialization and intrahepatic shunt.