도플러 초음파검사는 정맥류출혈의 위험성을 판정하는데 유용한가?

Abstract

Background/Aims : Prediction of variceal bleeding has been based on the large variceal size and the red color sign observed during endoscopy. By comparing the characteristic hemodynamic features of Doppler ultrasonography between liver cirrhosis patients with and without variceal bleeding, we aimed to evaluate the usefulness of Doppler ultrasonography in assessing the risk of variceal bleeding. Methods : One hundred patients with liver cirrhosis were divided into two groups: variceal bleeding group and non-variceal bleeding group. The diameter, mean velocity, and blood flow volume of the portal vein and splenic vein were measured in patients with and without variceal bleeding. The resistive index and pulsatility index of splenic artery, which have been known to reflect portal hypertension, were also measured in both groups. Results : In univariate analysis, we found that the values of the diameter and blood flow volume of the portal vein, and the diameter, mean velocity and blood flow volume of the splenic vein, and the size of spleen were significantly increased in the group with variceal bleeding. However, multivariate analysis (multiple logistic regression analysis) showed no significant independent value for the group with variceal bleeding. Conclusions : There is no single hemodynamic characteristic on Doppler ultrasonography which can assess the risk of variceal bleeding in patients with liver cirrhosis. It is likely that variceal bleeding is affected not by a single hemodynamic factor but by complex hemodynamic features of the portal system