Caletti G, Brocchi E, Baraldini M, Ferrari A, Gibilaro M, Barbara L
Academic Department of Medicine and Gastroenterology, University of Bologna, Italy.
Gastrointest Endosc. 1990 Mar-Apr;36(2 Suppl):S21-7. doi: 10.1016/s0016-5107(90)71011-5.
Endoscopic ultrasonography (EUS) was performed in 40 patients with portal hypertension (PH) and in 48 control subjects. The azygous, splenic, mesenteric, and portal veins were displayed in both groups. However, esophageal and gastric varices, periesophageal and perigastric collateral veins, and submucosal gastric venules were displayed only in patients with portal hypertension. EUS was inferior to endoscopy in detecting and grading esophageal varices (p less than 0.0005), but EUS was superior in the detection of varices in the fundus of the stomach (p less than 0.0005). Detection of periesophageal veins by EUS increased with increasing diameter of esophageal varices at endoscopy (57% in grade 1, 89% in grade 2, and 100% in grade 3), and there was a direct correlation between endoscopic grade and the diameter of the periesophageal collateral veins at EUS. The diameter of the azygous vein by EUS at its distal and proximal margins was significantly greater in patients with PH (p less than 0.001); the EUS diameter of the azygous vein was significantly larger with variceal grade 2 compared with grade 1 (p less than 0.02 and p less than 0.01, respectively). In portal hypertensive gastropathy, endoscopic and EUS detection were coincident. No correlation was found between the presence of portal hypertensive gastropathy, endoscopic grade of esophageal varices, and detection of gastric varices at EUS.
对40例门静脉高压（PH）患者和48例对照者进行了内镜超声检查（EUS）。两组均显示了奇静脉、脾静脉、肠系膜静脉和门静脉。然而，仅在门静脉高压患者中显示了食管和胃静脉曲张、食管周围和胃周围侧支静脉以及胃黏膜下小静脉。EUS在检测和分级食管静脉曲张方面不如内镜（p<0.0005），但在检测胃底静脉曲张方面优于内镜（p<0.0005）。EUS对食管周围静脉的检测随着内镜下食管静脉曲张直径的增加而增加（1级为57%，2级为89%，3级为100%），且内镜分级与EUS下食管周围侧支静脉直径之间存在直接相关性。PH患者EUS测量的奇静脉远端和近端边缘直径显著更大（p<0.001）；与1级静脉曲张相比，2级静脉曲张患者的EUS测量奇静脉直径显著更大（分别为p<0.02和p<0.01）。在门静脉高压性胃病中，内镜检查和EUS检测结果一致。未发现门静脉高压性胃病的存在、食管静脉曲张的内镜分级与EUS检测胃静脉曲张之间存在相关性。
