Feasibility spectrum for Doppler flowmetry of splanchnic vessels. In normal and cirrhotic populations.

Abstract

The calculation of absolute blood flow by Doppler flow~ metry requires adequate visualization of a vessel in both transverse and longitudinal planes and an insonating angle <6o•. The percentage of the splanchnic vessels in a given population in which these criteria could be ful· filled (ie, the feasibility spectrum) is not known. To identify this spectrum in our patient sample, 100 consecutive nonselected patients (58 female, 42 male) and 34 cirrhotics (31 male, three female) were prospectively studied. In addition, from the group of 42 nonselected patients, 31 males with no evidence of liver disease were matched for age, weight, and height with the 31 male cirrhotics. The echo-Doppler feasibility (EDF; success percentage) was determined for the hepatic, superior mesenteric, and splenic arteries and portal, superior mesenteric, and splenic veins. In the nonselected sample, the EDF varied from 86% for the portal vein to 60% D oppler flowmetry, because of its noninvasive nature, has been proposed as a promising method for the clinical study of splanchnic blood flow. for the superior mesenteric artery. In cirrhotics, the EDF ranged from 88% for portal vein to 29% in splenic artery. The total EDF for the nonselected sample (68%) was significantly higher than the EDF for cirrhotics (54o/o; P < .001). Physical factors (weight, age, height, and sex) affected the EDF in the nonselected patient sample but not in cirrhotics. We conclude that analysis of EDF of splanchnic vessels in these groups clearly demonstrates that the composition of the patient sample has an important bearing on the feasibility spectrum of Doppler study. Female subjects who are thin, young, and short and lighter male patients are better candidates for abdominal Doppler flowmetry. KEY WORDS: splanchnic ves· sets, blood flow measurements; cirrhosis, ultrasound studies; ultrasound, Doppler studies. J Ultrasound Med 9:705, 1990) some concern regarding the reproducibility and accuracy of this method. s- 11 An important source of variation could be the selection of patients, especially when patients in whom the vessels are not optimally imaged for Doppler measurement are excluded. In fact, Doppler measurements obtained by investigators in a given sample have not always been reproduced in another sample. 9 • 10 Because studies are performed only in patients in whom Doppler studies are feasible, it seems important that one should study the influence of patient characteristics in a given group on echo-Doppler feasibility (EDF) before interpreting and comparing Doppler flowmetry results from different subjects.Moreover

Duplex ultrasonography of superior mesenteric artery: interobserver variability

“…Among insonation technical factors influencing duplex results, 1 7 17%. Adding 0.2 mm of interobserver variability, this error increases to 22%.…”

Sonographic and Doppler assessment of the inferior mesenteric artery: normal morphologic and hemodynamic features

“…Studies also have been conducted to assess the variability of Doppler findings related to larger splanchnic vessels (both arterial and venous) and to compare the accuracy of these findings with those obtained by angiography [15][16][17]. The first report of this type regarding the IMA was published by our group following a preliminary study of normal and pathological cases [8].…”

Assessment of splanchnic blood flow using magnetic resonance imaging

“…The development of more modern methods, such as ultrasound, computed tomography, and MRI, however, has allowed noninvasive imaging of visceral vessels. Doppler sonography has been used to assess mesenteric hemodynamics [16,17], but measurement of Doppler sonographic mesenteric flow is not always feasible [18] and substantial interinvestigator variability has been reported. Cine phase-contrast MRI has been proposed as a promising method to quantitatively evaluate mesenteric hemodynamics [19].…”