Is non-invasive diagnosis of esophageal varices in patients with compensated hepatic cirrhosis possible by duplex Doppler ultrasonography?

Objective The purpose of this study was to visualize the shunt flow of arteriovenous fistulas (AVFs) passing towards the top side of the foot from the plantar artery. Methods Colour-flow duplex Doppler ultrasonography was performed in 112 patients who consulted an outpatient clinic with varicose veins and/or symptoms such as foot oedema, dullness, cramp and coldness. Thirteen age-and sex-matched healthy subjects served as controls. Results AVFs were detected in 86 of 112 patients (77%). They were also detected in 10 (77%) of 13 healthy subjects. The shunt flow pattern consisted of two phases of flow corresponding to systole and diastole, and the diastolic fraction of time–velocity integral was larger, although the peak flow velocity in systole was higher than that in diastole. Conclusion Colour-flow duplex Doppler ultrasonography is useful for non-invasive visualization of the shunt flow of AVFs connecting the plantar artery with the venous arch of the top side of the foot.

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A72 NON-INVASIVE PREDICTION OF ESOPHAGEAL VARICES BY TRANSIENT ELASTOGRAPHY AND PLATELET COUNT IN PATIENTS WITH HEPATITIS B AND ADVANCED CHRONIC LIVER DISEASE: VALIDATION OF BAVENO VI AND EXPANDED BAVENO VI CRITERIA

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.070 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 37-38

Author(s):

A Zoughlami ◽

J Serero ◽

G Sebastiani ◽

M Deschenes ◽

P Wong ◽

...

Keyword(s):

Platelet Count ◽

Liver Disease ◽

Hepatitis B ◽

Chronic Liver Disease ◽

Esophageal Varices ◽

Diagnostic Performance ◽

Transient Elastography ◽

Chronic Liver ◽

Non Invasive ◽

Chronic Hepatitis B Virus

Abstract Background Patients with compensated advanced chronic liver disease (cACLD) are at higher risk of developing complications from portal hypertension, including esophageal varices (EV). Baveno VI and expanded Baveno VI criteria, based on liver stiffness measurement (LSM) by transient elastography combined with platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for large esophageal varices needing treatment (EVNT). This approach has not been validated in patients with chronic hepatitis B virus (HBV) infection, who have etiology-specific cut-off of LSM for liver fibrosis. Aims We aimed to validate the Baveno VI and expanded Baveno VI criteria for EVNT in HBV patients with cACLD. Methods We performed a retrospective analysis of HBV patients who underwent LSM in 2014–2020. Inclusion criteria were: a) diagnosis of cACLD, defined as LSM >9 kPa; b) availability of EGD and platelets within 1 year of LSM. Baveno VI (LSM <20 kPa and platelets >150,000) and expanded Baveno VI criteria (LSM <25 kPa and platelets >110,000) were tested for EGD sparing. Diagnostic performance of these criteria against gold standard (EGD) was computed and compared to patients with hepatitis C virus (HCV) infection and nonalcoholic steatohepatitis (NASH) etiologies, where these criteria have been widely validated. In these patients, the threshold for cACLD definition was >10 kPa. Results A total of 287 patients (mean age 56, 95% Child A) were included, comprising of 43 HBV (58% on antiviral therapy), 134 HCV and 110 NASH patients. The prevalence of any grade EV and EVNT was 25% and 8% in the whole cohort, with 19% and 5% in HBV patients, respectively. Table 1 reports diagnostic performance, spared EGD and missed EVNT according to non-invasive criteria and cACLD etiology. Both Baveno VI and expanded Baveno VI criteria performed well in patients with HBV-related cACLD. There was no significant difference on diagnostic performance of these non-invasive criteria across the cACLD etiologies. Conclusions These results support use of non-invasive criteria based on LSM and platelets to spare unnecessary EGD in patients with HBV and cACLD. Baveno VI and expanded Baveno VI criteria can improve resource utilization and avoid invasive testing in context of screening EGD for patients with HBV-related cACLD. Funding Agencies None

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Non-invasive translational Cynomolgus model for studying folliculogenesis and ovulation using color Doppler ultrasonography

Journal of Medical Primatology ◽

10.1111/j.1600-0684.2011.00514.x ◽

2011 ◽

Vol 41 (1) ◽

pp. 18-23 ◽

Cited By ~ 1

Author(s):

Harry A. van Diepen ◽

Jeffrey Pansier ◽

Paul Oude Wesselink ◽

Aric van Drie ◽

Marcel van Duin ◽

...

Keyword(s):

Doppler Ultrasonography ◽

Color Doppler ◽

Color Doppler Ultrasonography ◽

Non Invasive

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Performance of Non-Invasive Liver Function Tests and Abdominal Ultrasound in the Prediction of Esophageal Varices

10.1055/s-0041-1724549 ◽

2021 ◽

Author(s):

N Trad ◽

M Ghanem ◽

B Ben slimen ◽

K Boughoula ◽

S Bizid ◽

...

Keyword(s):

Liver Function ◽

Esophageal Varices ◽

Abdominal Ultrasound ◽

Liver Function Tests ◽

Non Invasive ◽

Function Tests

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Duplex doppler ultrasonography of the intrarenal arteries: Normal and pathological findings (In French)

Clinical Imaging ◽

10.1016/0899-7071(92)90077-m ◽

1992 ◽

Vol 16 (3) ◽

pp. 218

Keyword(s):

Doppler Ultrasonography ◽

Pathological Findings ◽

Duplex Doppler

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Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

International Journal of Nephrology and Renovascular Disease ◽

10.2147/ijnrd.s27628 ◽

2011 ◽

pp. 15 ◽

Cited By ~ 2

Author(s):

Muhammad Ali ◽

R Sayani ◽

K Shazlee ◽

RS Hamid ◽

K Hamid

Keyword(s):

Urinary Tract ◽

Doppler Ultrasonography ◽

Renal Colic ◽

Functional Evaluation ◽

Acute Renal Colic ◽

Duplex Doppler

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Resistive Index of Intrarenal Artery in Evaluation of Diabetic Nephropathy

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v41i3.29888 ◽

2016 ◽

Vol 41 (3) ◽

pp. 125-130

Author(s):

Mahbuba Shirin ◽

Mofazzal Sharif ◽

Ayeshna Gurung ◽

Anindita Datta

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Serum Creatinine ◽

Renal Dysfunction ◽

Doppler Ultrasonography ◽

Resistive Index ◽

Diabetic Patients ◽

Type I ◽

The Mean ◽

Duplex Doppler

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (? 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.

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