1Department of Internal Medicine, Fujiyoshida Municipal Hospital, 2Second Department of Internal Medicine Showa University School of Medicine, 3Department of Surgery Showa University School of Medicine
We evaluated the clinical usefulness of color Doppler echography in diagnosing extrahepatic portal venous obstruction (EHO). The clinical application of Doppler color flow imaging for diagnosis of EHO has not been studied sufficiently. We examined 11 patients with EHO using SSH-65A and SSA-270A color Doppler echography equipment (Toshiba Co., Tokyo) with 3.75 MHz sector or convex probe. Patients were classified as primary (2 cases) or secondary (9 cases) EHO. Causes of the secondary form were considered to be liver cirrhosis, hepatocellular carcinoma, cholangitis, post-splenectomy or hematological disorder. Blood flow in the portal vein and cavernomatous transformation was easily observed in all cases (100%) of EHO by color Doppler echography. EHO was diagnosed in 8 (73%) of 11 patients with EHO by B-mode ultrasonography. Color Doppler echography was also evaluated for clinical usefulness and the following conclusions were revealed: 1. Blood flow and direction could be easily detected, and the velocity could be measured portal vein cavernomatous transformation. 2. It was possible to distinguish cavernomatous transformation from hepatic artery and bile duct in the porta hepatis. 3. Blood flows in non-obstructed portal vein and collateral veins could be evaluated. Doppler color flow imaging is useful not only for diagnosing EHO, but also for evaluating portal hemodynamics.