Esophageal varices: correlation of left gastric venography and endoscopy in patients with portal hypertension.
Esophageal varices: correlation of left gastric venography and endoscopy in patients with portal hypertension.
复制标题
食管静脉曲张：门脉高压患者左胃静脉造影与内镜检查的相关性。
DOI：
10.1148/radiology.155.2.3983381
复制
发表时间：
1985
期刊：
影响因子：
19.7
通讯作者：
K. Okuda
中科院分区：
文献类型：
--
作者：
M. Takashi;M. Igarashi;S. Hino;H. Musha;K. Takayasu;M. Arakawa;T. Nakashima;K. Ohnishi;K. Okuda
对100例门脉高压症患者行经皮肝穿插管选择性胃左静脉造影，观察其血流动力学及胃左支循环情况。血流为离肝型81例，胃左静脉供血63例，奇/半奇侧支27例，胃肾分流18例，其他侧支58例。79例静脉造影显示食管胃交界处由细小的平行血管发出的粗大、曲折的静脉，与胃镜下的静脉曲张在大小和走行上一致。静脉造影未能显示内窥镜下可见的细小静脉曲张，而内窥镜检查常将非曲张静脉解释为静脉曲张。以胃镜为参照，静脉造影诊断静脉曲张的敏感性为76%，特异性为100%，准确性为78%。静脉造影显示静脉曲张与既往呕血有显著相关性。胃左静脉造影在静脉曲张栓塞术前是必要的，在静脉曲张的诊断、血流动力学研究和出血风险评估中也是有用的。
Selective left gastric venography was performed via percutaneous transheptic catheterization in 100 patients with portal hypertension to study hemodynamics and left gastric collaterals. Flow was hepatofugal in 81 patients, while 63 had varices supplied by the left gastric vein; azygos/hemiazygos collaterals were seen in 27 patients, gastrorenal shunts in 18, and other collaterals in 58. In 79 cases, enlarged, tortuous veins arising from thin parallel vessels at the esophagogastric junction on venography corresponded with varices on endoscopy in both size and course. Venography failed to show small varices which were seen endoscopically, whereas endoscopy often interpreted non-tortuous veins as varices. Using endoscopy as a reference, the sensitivity of venography for varices was 76%, specificity 100%, and accuracy 78%. There was a significant correlation between venographic demonstration of varices and previous hematemesis. Left gastric venography is necessary prior to embolization of varices and is also useful in their diagnosis as well as study of hemodynamics and assessment of bleeding risk.