American Journal of Roentgenology, Vol 161, 563-567, Copyright © 1993 by American Roentgen Ray Society
Splenic venous flow exceeding portal venous flow at Doppler sonography: relationship to portosystemic varices
RC Nelson, GM Sherbourne, HB Spencer and JL Chezmar
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
OBJECTIVE. The purpose of this study was to determine if the Doppler
sonographic finding of hepatopetal flow in the splenic vein that exceeds
hepatopetal flow in the portal vein is associated with portosystemic
varices. MATERIALS AND METHODS. Sixty-four patients with chronic liver
disease were studied retrospectively. In 32 patients, splenic venous flow
exceeded portal venous flow (S > P group); in 32 patients, portal venous
flow exceeded splenic venous flow (P > S group). All patients were
evaluated with Doppler sonography and CT of the upper part of the abdomen.
Upper endoscopy was performed within 3 months of sonography in 44 of the 64
patients. RESULTS. In the S > P group, mean splenic volume was
significantly larger (p = .02) than in the other group. The prevalence of
varices as determined by CT in the esophageal, coronary, and peripancreatic
regions was also higher in this group (p < or = .01). When esophageal
varices were present, they were judged on the basis of their CT appearance
to be massive in 50% of the S > P group and in 0% of the P > S group.
Upper endoscopy revealed esophageal varices in 92% of the S > P group
and in 55% of the P > S group (p < .005). Bleeding esophageal varices
were noted in 75% of the S > P group and in 30% of the P > S group (p
< .01). CONCLUSION. Patients with chronic liver disease and the Doppler
sonographic finding of splenic venous flow that exceeds portal venous flow
have an increased prevalence of portosystemic varices, which tend to be
larger and more likely to bleed.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
