Objective: The aim of this study was to evaluate the hemodynamics of gastric varices with percutaneous color Doppler ultrasonography.
Methods: We evaluated 41 patients with gastric varices. Twenty-eight patients had enlarged tortuous varices and 13 had large, coil-shaped type. We examined color flow images and measured velocity of blood flow in gastric varices using pulsed Doppler analysis. We evaluated the detection rates of gastric varices and out-flowing vessels from gastric varices on 41 gastric variceal patients using color Doppler ultrasonography compared with computed tomography.
Results: The detection rates of gastric varices with color Doppler ultrasonography were 41 of the 41 patients (100%) and out-flowing vessels in 34 of the 41 patients (82.9%). The out-flowing vessels were found to be gastro-renal shunt (GRS) in 32 and GRS + subphrenic vein in two. Next, we evaluated the velocity of blood flow in the gastric varices. Thirteen of large, coil-shaped gastric varices had mean velocity of 23.0 cm/sec, 28 of enlarged tortuous gastric varices had mean velocity of 14.1 cm/sec. The mean velocity of large, coil-shaped varices was significantly higher than that of enlarged tortuous varices (p<0.01). The detection rates of collateral veins using computed tomography were: gastric varices in 41 of the 41 patients (100%) and out-flowing vessels in 38 of the 41 patients (92.7%). The color Doppler findings agreed perfectly with the computed tomography findings in 35 of the 41 patients (85.4%).
Conclusions: Percutaneous color Doppler ultrasonography is a non-invasive useful modality for diagnosis of the hemodynamics of gastric varices.