Contrast enhanced ultrasonography to improve the determination of blood flow in lower esophageal mucosa of patients with hepatoceller carcinoma

The diagnosis of esophageal varices is relevant to the determination of blood flow in the collateral vessels. Previously we have shown that the introduction of contrast enhancement to the routine ultrasonography (US), which improved the standard US system allowed evaluation of blood flow in the esop...

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Published inJapanese Journal of Portal Hypertension Vol. 15; no. 3; pp. 221 - 226
Main Authors Abe, Hisako, Hiroi, Yoshikazu, Otani, Takeshi, Moriyama, Mitsuhiko, Matsumoto, Naoki, Nakagawara, Hiroshi, Ogawa, Masahiro, Abe, Masahisa, Tanaka, Naohide, Nishiyama, Ryu, Ogihara, Akifumi
Format Journal Article
LanguageJapanese
Published The Japan Society for Portal Hypertension 2009
日本門脈圧亢進症学会
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ISSN1344-8447
2186-6376
DOI10.11423/jsph.15.221

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Abstract The diagnosis of esophageal varices is relevant to the determination of blood flow in the collateral vessels. Previously we have shown that the introduction of contrast enhancement to the routine ultrasonography (US), which improved the standard US system allowed evaluation of blood flow in the esophageal varices. We compared our observations on esophageal varix between endoscopy and contrast enhanced US, and assessed the diagnostic power of contrast enhanced US in the management of esophageal varix. US was performed in 50 patients with hepatoceller carcinoma. Based on the examinations of the form and the red color sign in the contrast enhanced US, we were able to visualize the esophageal varices and select candidates for treatment at high rates. Approximately 90% of esophageal varix cases in which the lumen of the lower esophagus was strongly enhanced showed indications for treatment. This improved version of US was minimally invasive and enabled us to detect varices as candidates for treatment at a high rate. Contrast enhanced US was thought to be a useful modality to evaluate blood flow of esophageal varices.
AbstractList The diagnosis of esophageal varices is relevant to the determination of blood flow in the collateral vessels. Previously we have shown that the introduction of contrast enhancement to the routine ultrasonography (US), which improved the standard US system allowed evaluation of blood flow in the esophageal varices. We compared our observations on esophageal varix between endoscopy and contrast enhanced US, and assessed the diagnostic power of contrast enhanced US in the management of esophageal varix. US was performed in 50 patients with hepatoceller carcinoma. Based on the examinations of the form and the red color sign in the contrast enhanced US, we were able to visualize the esophageal varices and select candidates for treatment at high rates. Approximately 90% of esophageal varix cases in which the lumen of the lower esophagus was strongly enhanced showed indications for treatment. This improved version of US was minimally invasive and enabled us to detect varices as candidates for treatment at a high rate. Contrast enhanced US was thought to be a useful modality to evaluate blood flow of esophageal varices.
The diagnosis of esophageal varices is relevant to the determination of blood flow in the collateral vessels. Previously we have shown that the introduction of contrast enhancement to the routine ultrasonography (US), which improved the standard US system allowed evaluation of blood flow in the esophageal varices. We compared our observations on esophageal varix between endoscopy and contrast enhanced US, and assessed the diagnostic power of contrast enhanced US in the management of esophageal varix. US was performed in 50 patients with hepatoceller carcinoma. Based on the examinations of the form and the red color sign in the contrast enhanced US, we were able to visualize the esophageal varices and select candidates for treatment at high rates. Approximately 90% of esophageal varix cases in which the lumen of the lower esophagus was strongly enhanced showed indications for treatment. This improved version of US was minimally invasive and enabled us to detect varices as candidates for treatment at a high rate. Contrast enhanced US was thought to be a useful modality to evaluate blood flow of esophageal varices. 食道静脈瘤の診断においては,血流評価が重要である.一方体外式超音波ドプラ装置は造影検査の導入と装置の改良により,ある程度食道静脈瘤の血流評価が可能であることが分かってきた.そこで我々は,肝細胞癌合併肝硬変50症例に対し,内視鏡所見と造影超音波検査所見の比較を行い,造影超音波検査の有用性を検討した.F因子およびred color signとの比較検討により,造影超音波検査は治療適応の食道静脈瘤を高率に描出できることが確認された.造影超音波検査で下部食道の内腔が強く造影される症例は,治療適応のある食道静脈瘤の約90%に認められた.以上から造影超音波検査は,治療適応のある食道静脈瘤の存在を高率に把握できかつ,低侵襲であるため,臨床上有用であると考える.
Author Abe, Masahisa
Otani, Takeshi
Tanaka, Naohide
Matsumoto, Naoki
Moriyama, Mitsuhiko
Abe, Hisako
Ogihara, Akifumi
Ogawa, Masahiro
Nakagawara, Hiroshi
Hiroi, Yoshikazu
Nishiyama, Ryu
Author_FL 中河原 浩史
荻原 章史
西山 竜
安倍 久子
阿部 真久
廣井 喜一
小川 眞広
田中 直英
森山 光彦
松本 直樹
大谷 豪
Author_FL_xml – sequence: 1
  fullname: 西山 竜
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  fullname: 小川 眞広
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  fullname: 荻原 章史
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  fullname: 安倍 久子
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  fullname: 阿部 真久
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  fullname: 松本 直樹
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  fullname: 中河原 浩史
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  fullname: 廣井 喜一
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  fullname: 大谷 豪
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  fullname: 田中 直英
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  fullname: Abe, Hisako
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  fullname: Hiroi, Yoshikazu
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  fullname: Matsumoto, Naoki
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  fullname: Abe, Masahisa
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  fullname: Tanaka, Naohide
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  organization: Department of Gastroenterology and Hepatology, Division of Gastroenterology and Hepatology, Nihon University School of Medicine, Surugadai Nihon University Hospital
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DocumentTitle_FL 肝細胞癌合併症例における体外式造影超音波検査による下部食道粘膜造影能と内視鏡検査所見との比較検討
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References 9) Nishiyama R, Ogawa M, Nakajima N, et al: Utility of contrast enhanced ultrasonography for evaluation of blood flow of esophageal varices. Nihon Univ J Med 2007; 49: 1-14
1) 日本門脈圧亢進症学会編:門脈圧亢進症取扱い規約,改訂第2版,金原出版,東京,2004; 37-38
8) Sato T, Yamazaki K, Toyota J, et al: Color doppler findings of gastric varices compared with findings on computed tomography. J Gastroenterol 2002; 37: 604-610
2) Obara K: Hemodynamic mechanism of esophageal varices. Dig Endosc 2006; 18: 6-9
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3) 庄司達弘,高橋 寛,山口芳美,他:食道静脈瘤の治療効果判定と長期予後—造影MR angiographyを用いた検討—.日門亢会誌 2000; 6: 138-144
4) Ono N, Toyonaga A, Nishimura H, et al: Evaluation of magnetic resonance angiography on portosystemic collaterals in cirrhotic patients. Am J Gastroenterol 1997; 92: 1515-1519
5) 佐藤隆啓,山崎 克,豊田成司,他:超音波内視鏡下カラードプラ法による食道・胃静脈瘤の診断ならびに治療効果判定.消化器内視鏡 2003; 15: 1077-1083
6) 小原勝敏:EUS所見からみた食道静脈瘤に対する治療戦略.日門亢会誌 2005; 11: 174-180
References_xml – reference: 9) Nishiyama R, Ogawa M, Nakajima N, et al: Utility of contrast enhanced ultrasonography for evaluation of blood flow of esophageal varices. Nihon Univ J Med 2007; 49: 1-14
– reference: 6) 小原勝敏:EUS所見からみた食道静脈瘤に対する治療戦略.日門亢会誌 2005; 11: 174-180
– reference: 2) Obara K: Hemodynamic mechanism of esophageal varices. Dig Endosc 2006; 18: 6-9
– reference: 4) Ono N, Toyonaga A, Nishimura H, et al: Evaluation of magnetic resonance angiography on portosystemic collaterals in cirrhotic patients. Am J Gastroenterol 1997; 92: 1515-1519
– reference: 1) 日本門脈圧亢進症学会編:門脈圧亢進症取扱い規約,改訂第2版,金原出版,東京,2004; 37-38
– reference: 8) Sato T, Yamazaki K, Toyota J, et al: Color doppler findings of gastric varices compared with findings on computed tomography. J Gastroenterol 2002; 37: 604-610
– reference: 5) 佐藤隆啓,山崎 克,豊田成司,他:超音波内視鏡下カラードプラ法による食道・胃静脈瘤の診断ならびに治療効果判定.消化器内視鏡 2003; 15: 1077-1083
– reference: 7) 中村真一,林 直諒:食道・胃静脈瘤の診断法(血管造影,X線,CT,超音波内視鏡).消化器病セミナー 2000; 81: 49-59
– reference: 3) 庄司達弘,高橋 寛,山口芳美,他:食道静脈瘤の治療効果判定と長期予後—造影MR angiographyを用いた検討—.日門亢会誌 2000; 6: 138-144
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SubjectTerms contrast-enhanced ultrasonography
esophageal varices
hepatoceller carcinoma
Title Contrast enhanced ultrasonography to improve the determination of blood flow in lower esophageal mucosa of patients with hepatoceller carcinoma
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