Caletti G C, Brocchi E, Ferrari A, Fiorino S, Barbara L
Department of Medicine and Gastroenterology, University of Bologna, Italy.
Endoscopy. 1992 May;24 Suppl 1:342-6. doi: 10.1055/s-2007-1010496.
Using endoscopic ultrasonography (EUS) a large part of the portal venous system can be visualized. In 40 patients with portal hypertension (PH) and in 48 control subjects EUS displayed the azygos, splenic, mesenteric and portal veins in both groups. However, esophageal and gastric varices, peri- esophageal and peri-gastric collateral veins and submucosal gastric venules were displayed only in patients with PH. EUS was inferior to endoscopy for detecting and grading esophageal varices (p less than 0.0005), but superior in the detection of varices in the fundus of the stomach (p less than 0.0005). EUS cannot be considered a reliable method for the study of esophageal varices: it has an overall sensitivity of 50%, does not permit flow measurements, and does not provide information that could be used to estimate the risk of bleeding. EUS has been demonstrated to be superior to endoscopy in the diagnosis of gastric varices. This finding is extremely important for the optimal selection of treatment of patients with portal hypertension. EUS can detect portal hypertensive gastropathy; thus inflammatory gastritis can be more easily distinguished from congestive gastropathy and therapeutic decisions are strongly influenced.
使用内镜超声检查（EUS）可以观察到大部分门静脉系统。在40例门静脉高压（PH）患者和48例对照受试者中，EUS显示了两组的奇静脉、脾静脉、肠系膜静脉和门静脉。然而，食管和胃静脉曲张、食管周围和胃周围侧支静脉以及胃黏膜下小静脉仅在PH患者中显示。在检测和分级食管静脉曲张方面，EUS不如内镜检查（p<0.0005），但在检测胃底静脉曲张方面更具优势（p<0.0005）。EUS不能被认为是研究食管静脉曲张的可靠方法：其总体敏感性为50%，不允许进行血流测量，也不能提供可用于估计出血风险的信息。EUS已被证明在诊断胃静脉曲张方面优于内镜检查。这一发现对于门静脉高压患者治疗的最佳选择极为重要。EUS可以检测出门静脉高压性胃病；因此，炎症性胃炎可以更容易地与充血性胃病区分开来，并且治疗决策会受到很大影响。
