Echo‐Doppler measurements of portal vein and superior mesenteric artery blood flow in humans: Inter‐ and intra‐observer short‐term reproducibility

Abstract

The reproducibility of echo‐Doppler measurements of portal vein and superior mesenteric artery blood flow has not been extensively studied. In the present study, two groups of subjects were examined to test inter‐ and intra‐observer reproducibility. Each study population consisted of 15 non‐portal hypertensive and 15 portal hypertensive subjects. With a standardized technique, the cross‐sectional area and velocity of blood flow in the portal vein and superior mesenteric artery were recorded in triplicate by skilled operators. The flow volume of each vessel was calculated by multiplying the cross‐sectional area by the velocity of blood flow. The measurements were performed in a blind fashion over a 60 min period. The reproducibility of measurements was assessed by calculation of intraclass correlation coefficients and coefficients of variation. The intra‐observer intraclass correlation coefficient was 0.77 for portal vein blood flow and 0.84 for superior mesenteric artery blood flow, suggesting good reproducibility. The intra‐observer coefficient of variation was 11 and 9%, respectively. In contrast, the interobserver intraclass correlation coefficient was calculated to be 0.49 for portal blood vein blood flow and 0.57 for superior mesenteric artery blood flow, indicating fair reproducibility. In addition, the interobserver coefficients of variation were calculted to be 20 and 18%, respectively. These data suggest that intra‐observer reproducibility in echo‐Doppler measurements of portal vein and superior mesenteric artery blood flow is acceptable but inter‐observer reproducibility is not. Examination by a single operator, rather than multiple operators, is therefore advisable. Even when measurements are performed by a single investigator an approximate variance of 10% in the measurement in a single subject should be expected.

Asymmetric evolution of anterior chest wall blood supply in female adolescents with progressive right-convex thoracic idiopathic scoliosis

“…The blood supply to the anterior chest wall, besides IMA, is also derived from several other arteries which however cannot be measured with the existed CDU methods because of their fine anatomy and thus they were not included in the present study. Sevastik et al [1,2] suggested the asymmetric increase of blood supply to the left anterior chest wall as a possible cause of right-convex idiopathic scoliosis in girls, while recent studies with CDU [3][4][5] in these individuals doubted this theory of asymmetry because they did not find any asymmetry in blood supply to the anterior chest wall. However, all these studies did not investigate the evolution of blood supply to the anterior chest wall of the female adolescent scoliotics.…”

“…However, all these studies did not investigate the evolution of blood supply to the anterior chest wall of the female adolescent scoliotics. The present study is advantageous to previous studies [3][4][5] because it is prospective, controlled, and used radiographic and CDU-data derived from two consequent measurements within a 2-year period.…”

“…Recent studies [3][4][5] measured with CDU anatomic and hemodynamic parameters of IMA, in an attempt to shed light in the aetiology of thoracic right-convex idiopathic female scoliosis [6]. The blood supply to the anterior chest wall, besides IMA, is also derived from several other arteries which however cannot be measured with the existed CDU methods because of their fine anatomy and thus they were not included in the present study.…”

“…All previously published studies on the anterior chest wall blood supply [1][2][3][4][5] were based on single observations and thus had the limitation of lack of follow up.…”

“…Internal mammary artery (IMA) is anatomically the main blood distributor to the anterior thorax wall. Recent, comparative Colour Doppler Ultrasonography (CDU)-studies of IMA-anatomic and hemodynamic parameters in scoliotics with right thoracic curves versus non-scoliotic female adolescents did not disclose any differences or even IMA side-asymmetry [3][4][5].…”