松谷 正一, 石井 浩, 古瀬 純司, 黒沢 俊介, 大藤 正雄

Shoichi MATSUTANI, Hiroshi ISHII, Junji FURUSE, Shunsuke KUROSAWA , Masao OHTO

千葉大学医学部第一内科

The First Department of Medicine, School of Medicine, Chiba University

キーワード : Doppler ultrasound, Color flow imaging, Extracorporal scan, Esophageal varices, Hemodynamics

A new method for detecting blood flow in esophageal varices is described in this paper. Blood flow in the wall of the esophagus was examined by Doppler ultrasound from the skin surface in patients with esophageal varices. Detection of blood flow signals were possible in 25 of 42 patients with esophageal varices. No flow signals were obtained in the wall of the esophagus in healthy controls nor in patients without esophageal varices. These blood flow signals showed a venous flow pattern and were obserbed in the low echo zone in the wall of the esophagus. Color flow imaging of esophageal varices was also obtained in these patients. Blood flow was detected in most patients with large esophageal varices, but was difficult to detect it in small varices. The degree of hepatofugal blood flow in the left gastric vein was also an important factor in the detection of variceal blood flow by using this method. As blood flow in the left gastric vein increased after oral intake of glucose, blood flow in the wall of the esophagus increased proportionally. Doppler ultrasound examination from the skin surface is a useful and non-invasive method for evaluating variceal hemodynamics.