The Clinical Value of Color Doppler Ultrasound for Prehepatic Portal Hypertension_West China Medical Journal

Authors：

 TangShanhong ¹ , LiangYan ² ,  ZengWeizheng ¹ , ZhouXiaolei ¹ , LiHongyong ¹ , DengDan ² , JiangMingde ¹

1. Department of Gastroenterology;Chengdu Military General Hospital, Chengdu, Sichuan 610083, P. R. China;
2. Department of Ultrasound;Chengdu Military General Hospital, Chengdu, Sichuan 610083, P. R. China;

Corresponding author：

ZengWeizheng, Email: zengweizheng@163.com

Keywords：

Prehepatic portal hypertension; Color Doppler ultrasound; Artery-portal vein fistula; Splenic vein thrombosis

DOI：

10.7507/1002-0179.201600423

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical value of color Doppler ultrasound in diagnosing prehepatic portal hypertension. Methods A retrospective analysis was performed to analyze the results of color Doppler ultrasonography in 9 patients with prehepatic portal hypertension diagnosed between June 2012 and January 2015, including vessel diameter, shape, nature and direction of blood flow, and fistula blood flow spectrum. Results Among the 9 patients, the color Doppler ultrasound found 3 patients with regional portal widened, increased and faster blood flow with the emergence of low-impedance spectrum artery, splenic vein widened with returning blocked and flocculent substance within the splenic vein lumen, irregular or streak-shaped low weak echo during splenic vein reduction, and unstable or weakened blood flow velocity. Two patients were confirmed with splenic vein thrombosis by ultrasound and other imaging methods with significantly reduced blood in splenic vein. For the other four patients with regional portal hypertension, obvious abnormalities in portal system were not detected by color Doppler ultrasound, but they were checked with other methods. The ultrasound positive diagnosis of the 9 patients was 5, with 4 missed. Conclusion The color Doppler ultrasound has some values in screening, diagnosis and follow-up of prehepatic portal hypertension, but it can also be influenced by many factors with a high missed diagnosis rate. Carefully observing the portal system lumen structure, internal echo and blood flow combined with other imaging studies, and emphasizing clinical history of the patients can further improve diagnostic accuracy.

Citation： TangShanhong, LiangYan, ZengWeizheng, ZhouXiaolei, LiHongyong, DengDan, JiangMingde. The Clinical Value of Color Doppler Ultrasound for Prehepatic Portal Hypertension. West China Medical Journal, 2016, 31(9): 1554-1557. doi: 10.7507/1002-0179.201600423 Copy

1.	Loftus JP, Nagorney DM, Ilstrup D, et al. Sinistral portal hypertension. Splenectomy or expectant management[J]. Ann Surg, 1993, 217(1):35-40.
2.	Hii HP, Wu ZH, Yeh ML, et al. Successful coil embolization of an unusual aorto-superior mesenteric vein fistula[J]. J Vasc Surg, 2009, 49(5):1310-1312.
3.	Gabriel S, Maroney TP, Ringe BH. Hepatic artery-portal vein fistula formation after percutaneous liver biopsy in a living liver donor[J]. Transplant Proc, 2007, 39(5):1707-1709.
4.	Wo;źniak W, Mlosek RK, Miłek T, et al. Splenic arteriovenous fistula--late complications of splenectomy[J]. Acta Gastroenterol Belg, 2011, 74(3):465-467.
5.	汤善宏, 曾维政, 何乾文, 等. 胰腺炎后区域性门静脉高压1例[J]. 西南国防医药, 2015, 25(8):928.
6.	汤善宏, 何煊, 王钊, 等. 部分脾动脉栓塞治疗慢性胰腺炎相关脾静脉血栓致区域性门静脉高压1例报告[J]. 临床肝胆病杂志, 2015, 31(5):771-772.
7.	Tang SH, Zeng WZ, He QW, et al. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding:a case report and review[J]. World J Clin Cases, 2015, 3(10):920-925.
8.	汤善宏, 何卿玮, 何乾文, 等. 胰腺脓肿压迫脾静脉致区域性门静脉高压1例报告[J]. 临床肝胆病杂志, 2015, 31(5):773-774.
9.	汤善宏, 秦建平, 蒋明德, 等. 动脉-门静脉系统异常分流致门静脉高压诊断与治疗进展[J]. 中华肝脏病杂志, 2015, 23(6):86-88.
10.	汤善宏, 杨德会, 曾维政, 等. 外伤后肠系膜上动静脉瘘致区域性门静脉高压一例[J]. 中华消化杂志, 2015, 35(10):709-712.
11.	Qin J, Tang S, Jiang M, et al. Portal hypertension caused by right common iliac artery-superior mesenteric vein fistula[J]. Jpn J Radiol, 2015, 33(5):291-294.
12.	汤善宏, 王钊, 庞玉玲, 等. 断流胃冠状静脉治疗胃底静脉曲张破裂出血都对吗?谈区域性门静脉高压发病原因及临床诊治[J]. 医学争鸣, 2016, 5(7):23-27.
13.	Sachdeva R, Yapor M, Schwersenz A, et al. Massive variceal bleeding caused by a hepatic artery-portal vein fistula:a manifestation of hepatocellular carcinoma in a 12-year-old[J]. J Pediatr Gastroenterol Nutr, 1993, 16(4):468-471.
14.	Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis:a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding[J]. HPB (Oxford), 2011, 13(12):839-845.
15.	Köklü S, Coban S, Yüksel O, et al. Left-sided portal hypertension[J]. Dig Dis Sci, 2007, 52(5):1141-1149.
16.	Saugel B, Gaa J, Phillip V, et al. Splenic artery embolization in a Woman with bleeding gastric varices and splenic vein thrombosis:a case report[J]. J Med Case Rep, 2010, 4:247.
17.	Luo X, Nie L, Wang Z, et al. Transjugular endovascular recanalization of splenic vein in patients with regional portal hypertension complicated by gastrointestinal bleeding[J]. Cardiovasc Intervent Radiol, 2014, 37(1):108-113.
18.	汤善宏, 曾维政, 陈虹彬, 等. 区域性门静脉高压致胃底静脉曲张出血内镜下组织胶注射疗效分析[J]. 临床肝胆病杂志, 2015, 31(8):1283-1286.

1. Loftus JP, Nagorney DM, Ilstrup D, et al. Sinistral portal hypertension. Splenectomy or expectant management[J]. Ann Surg, 1993, 217(1):35-40.
2. Hii HP, Wu ZH, Yeh ML, et al. Successful coil embolization of an unusual aorto-superior mesenteric vein fistula[J]. J Vasc Surg, 2009, 49(5):1310-1312.
3. Gabriel S, Maroney TP, Ringe BH. Hepatic artery-portal vein fistula formation after percutaneous liver biopsy in a living liver donor[J]. Transplant Proc, 2007, 39(5):1707-1709.
4. Wo;źniak W, Mlosek RK, Miłek T, et al. Splenic arteriovenous fistula--late complications of splenectomy[J]. Acta Gastroenterol Belg, 2011, 74(3):465-467.
5. 汤善宏, 曾维政, 何乾文, 等. 胰腺炎后区域性门静脉高压1例[J]. 西南国防医药, 2015, 25(8):928.
6. 汤善宏, 何煊, 王钊, 等. 部分脾动脉栓塞治疗慢性胰腺炎相关脾静脉血栓致区域性门静脉高压1例报告[J]. 临床肝胆病杂志, 2015, 31(5):771-772.
7. Tang SH, Zeng WZ, He QW, et al. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding:a case report and review[J]. World J Clin Cases, 2015, 3(10):920-925.
8. 汤善宏, 何卿玮, 何乾文, 等. 胰腺脓肿压迫脾静脉致区域性门静脉高压1例报告[J]. 临床肝胆病杂志, 2015, 31(5):773-774.
9. 汤善宏, 秦建平, 蒋明德, 等. 动脉-门静脉系统异常分流致门静脉高压诊断与治疗进展[J]. 中华肝脏病杂志, 2015, 23(6):86-88.
10. 汤善宏, 杨德会, 曾维政, 等. 外伤后肠系膜上动静脉瘘致区域性门静脉高压一例[J]. 中华消化杂志, 2015, 35(10):709-712.
11. Qin J, Tang S, Jiang M, et al. Portal hypertension caused by right common iliac artery-superior mesenteric vein fistula[J]. Jpn J Radiol, 2015, 33(5):291-294.
12. 汤善宏, 王钊, 庞玉玲, 等. 断流胃冠状静脉治疗胃底静脉曲张破裂出血都对吗?谈区域性门静脉高压发病原因及临床诊治[J]. 医学争鸣, 2016, 5(7):23-27.
13. Sachdeva R, Yapor M, Schwersenz A, et al. Massive variceal bleeding caused by a hepatic artery-portal vein fistula:a manifestation of hepatocellular carcinoma in a 12-year-old[J]. J Pediatr Gastroenterol Nutr, 1993, 16(4):468-471.
14. Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis:a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding[J]. HPB (Oxford), 2011, 13(12):839-845.
15. Köklü S, Coban S, Yüksel O, et al. Left-sided portal hypertension[J]. Dig Dis Sci, 2007, 52(5):1141-1149.
16. Saugel B, Gaa J, Phillip V, et al. Splenic artery embolization in a Woman with bleeding gastric varices and splenic vein thrombosis:a case report[J]. J Med Case Rep, 2010, 4:247.
17. Luo X, Nie L, Wang Z, et al. Transjugular endovascular recanalization of splenic vein in patients with regional portal hypertension complicated by gastrointestinal bleeding[J]. Cardiovasc Intervent Radiol, 2014, 37(1):108-113.
18. 汤善宏, 曾维政, 陈虹彬, 等. 区域性门静脉高压致胃底静脉曲张出血内镜下组织胶注射疗效分析[J]. 临床肝胆病杂志, 2015, 31(8):1283-1286.

Previous Article
Comparison of Efficacy among Different Surgical Root Coverage Methods
Next Article
The Value of Multi-slice CT in the Diagnosis of Complications Due to Breast Augmentation

West China Medical Journal

The Clinical Value of Color Doppler Ultrasound for Prehepatic Portal Hypertension

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content