Valletta E A, Loreti S, Cipolli M, Cazzola G, Zanolla L
Dept. of Radiology, Ospedale Civile Maggiore, Verona, Italy.
Scand J Gastroenterol. 1993 Dec;28(12):1042-6. doi: 10.3109/00365529309098306.
To investigate the role of echo-Doppler flowmetry in evaluating patients with cystic fibrosis and portal hypertension at risk of esophageal varices, we studied 26 subjects divided in 3 groups: 9 with portal hypertension and esophageal varices, 8 with chronic liver disease without varices, and 9 without chronic liver disease. Spleen size, diameter, blood velocity, and flow rate of portal, splenic, and superior mesenteric veins were recorded. In patients without chronic liver disease Doppler measurements were repeated on 2 different days to assess intraobserver variability. Significant differences among the three groups were found for mean values of spleen size and diameters of portal, splenic, and superior mesenteric veins. Nevertheless, a considerable overlapping of individual data was observed. No differences were observed in mean hemodynamic measurements, except for blood velocity in portal vein and flow rate in splenic vein. The intraobserver variability for repeated Doppler measurements was clinically unacceptable for most of the variables studied. Echo-Doppler assessment of splanchnic flow seems to be an unreliable tool in the management of cystic fibrosis patients with portal hypertension at risk of esophageal varices.
为了研究超声多普勒血流仪在评估患有囊性纤维化和有食管静脉曲张风险的门静脉高压患者中的作用，我们对26名受试者进行了研究，将其分为3组：9名患有门静脉高压和食管静脉曲张，8名患有无静脉曲张的慢性肝病，9名无慢性肝病。记录了脾脏大小、门静脉、脾静脉和肠系膜上静脉的直径、血流速度和血流量。对于无慢性肝病的患者，在2个不同日期重复进行多普勒测量以评估观察者内变异性。发现三组之间在脾脏大小以及门静脉、脾静脉和肠系膜上静脉直径的平均值方面存在显著差异。然而，观察到个体数据有相当大的重叠。除门静脉血流速度和脾静脉血流量外，平均血流动力学测量值未观察到差异。对于大多数研究变量，重复多普勒测量的观察者内变异性在临床上是不可接受的。超声多普勒对内脏血流的评估似乎是管理有食管静脉曲张风险的囊性纤维化门静脉高压患者的不可靠工具。
