Changes in portosystemic collaterals after endoscopic injection sclerotherapy: focused on magnetic resonance angiography / 대한내과학회지

ABSTRACT

BACKGROUND: This study was aimed at evaluating the changes of collateral circulation, using MR angiography (MRA), which is a non-invasive and a useful tool for viewing the porto-systemic circulation as a whole, following endoscopic injection sclerotherapy (EIS). METHODS: 30 patients who have portal hypertension with esophageal varices have taken MRA before the sclerotherapy and followed up 1 month after the eradication. RESULTS: The collaterals observed before EIS are as follows left gastric vein 30 patients (100%), short gastric vein 2 patients (7%), gastro-renal shunt 2 patients (7%) and spleno-renal shunt 6 patients (20%). After the sclerotherapy, left gastric vein was obliterated in 12 patients (40%), decreased to 25% and 50% in 9 patients (30%) but, no change in 6 patients (20%), increased in 3 patients (10%). For short gastric vein, 25% and 50% size reduction was found in 2 patients. For gastro-renal shunt, no change in size was observed in 1 patient, increased to 25% in 1 patient. For spleno-renal shunt, it disappeared in 1 patients (17%) and decreased to 25% in 1 patient but, no change in 3 patients (50%), increased to 25% in 1 patients. CONCLUSION: Obliteration of left gastric vein was observed in many cases after the sclerotherapy and further evaluation is needed.