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[Spontaneous portasystemic shunt in liver cirrhosis: imaging with color-coded duplex ultrasonography]
J Riehl1, D Bongartz, H Nguyen
1Medizinische Klinik II, Universitätsklinik der Rheinisch-Westfälischen Technischen Hochschule Aachen.
Purpose:
To demonstrate the usefulness of B-scan ultrasonography and color Doppler ultrasonography (CCDS) in the diagnosis of lumbal and splenorenal collateral veins in patients with liver cirrhosis.
Method:
46 patients with histologically proven liver cirrhosis were examined by means of B-scan ultrasonography. CCDS was used to demonstrate the vascular character of mass-like lesions or tortuous tubular structures. Esophageal varices were demonstrated in 23 (50%) and ascites in 6 patients (13%).
Results:
In 5 out of 46 patients (10.9%) we demonstrated lumbal and splenorenal portosystemic venous collaterals by B-scan- and CCDS. In 2 patients localized venous collaterals were demonstrated. No ascites was found in patients with accessory portosystemic shunts. CCDS showed the patency of these spontaneous portosystemic shunts.
Conclusion:
In patients with chronic liver disease CCDS is a noninvasive method to demonstrate spontaneous portosystemic shunts due to portal hypertension. The method provides information concerning patency and flow direction of the collateral veins.