Clinical Gastroenterology Vol.15 No.5(3)

Theme Portal Hypertension
Title Imaging Findings of Portal Hypertension
Publish Date 2000/05
Author Yoshihiro Okabe Department of Gastroenterology and Hepatology, Kobe City General Hospital
Author Masatoshi Kudo Department of Gastroenterology and Hepatology, Kinki University School of Medicine
[ Summary ] Today various imaging modalities are widely applied to clinical assessment of portal hypertention. Extracorporeal ultrasonography is useful in easily detecting many characteristic findings, leading to an accurate diagnosis of the causes and pathophysiological conditions related to portal hypertention. Furthermore, also using a color Doppler method, we can correctly evaluate the particular hemodynamics of varicose veins, collateral routes, arterio-portal shunting etc. MR angiography makes it possible to clearly depict stereographic views of complicated collateral veins. Endoscopic procedures are indispensable in deciding the clinical stages of esophagogastric varices. Endoscopic varicealography, simultaneously performed with endoscopic injection sclerotherapy, can demonstrate a regional vascular network in detail. Intracorporeal ultrasound equipment, endoscopic ultrasonography and endoscopic color Doppler ultrasonography, are newly developed tools. The former is sensitive in demonstrating the minute structure of esophagogastric varices and the latter has the capability to assess intravariceal blood flow patterns. Therefore, by using various imaging modalities, the complex conditions of portal hypertension can be correctly assessed non-invasively, which provides an adequate decision making of therapeutic strategies as well as an adequate evaluation of these therapeutic responses.
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