| Theme |
Diagnosis and Treatment of Portal Hypertention |
| Title |
Diagnosis and Treatment of Esophageal Varices Based on 3 D-CT |
| Author |
Masaharu Takeuchi |
Miyoshi Hospital |
| Author |
Masao Tanooka |
Department of Clinical Radiology, The Hospital of Hyogo College of Medicine |
| Author |
Tomoko Sakai |
Miyoshi Hospital |
| Author |
Akiyoshi Shu |
North Osaka Police Hospital |
| Author |
Yoshiyuki Nakai |
Nakai Memorial Hospital |
| Author |
Koshi Oh |
First Department of Surgery, Hyogo College of Medicine |
| [ Summary ] |
The evaluation of portal hemodynamics is necessary for the treatment of esophageal varices. Using MD-CT (MIP method) we determined the feeding vein, the development of the para-esophageal vein (PEV), and the perforating vein. The hemodynamics of esophageal varices was classified into three types : PEV not developed (type I), PEV developed but diameter the same or less the size of esophageal vein (type II), and PEV with development greater than the diameter of the esophageal vein (type III). EVIS is recommended for the treatment of esophageal varices. For type I , total embolization to the LGV, and type II and III, partial embolization to the anterior branch of LGV is recommended. It was necessary to assess the target embolism range for type II, as it sometimes happens to embolise up to the root. Although PEV functions as a drainage vein, preventive consolidation therapy is required for recurrence control. |