Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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CT Findings after BRTO in Patients with Gastric Varix Bleeding: Can We Predict Varix Recurrence

위정맥류 출혈 환자에서 역행성경정맥위정맥류폐색술 후 전산화단층촬영 소견을 통한 위정맥류 재발의 예측

  • Kim, Joo-Hwan (Department of Radiology, Dongsan Medical Center, Keimyung University, College of Medicine) ;
  • Kim, Young-Hwan (Department of Radiology, Dongsan Medical Center, Keimyung University, College of Medicine) ;
  • An, Eun-Jung (Department of Radiology, Dongsan Medical Center, Keimyung University, College of Medicine) ;
  • Kim, See-Hyung (Department of Radiology, Dongsan Medical Center, Keimyung University, College of Medicine) ;
  • Choi, Jin-Soo (Department of Radiology, Dongsan Medical Center, Keimyung University, College of Medicine)
  • 김주환 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 김영환 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 안은정 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 김시형 (계명대학교 의과대학 동산의료원 영상의학과학교실) ;
  • 최진수 (계명대학교 의과대학 동산의료원 영상의학과학교실)
  • Published : 2011.02.01
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Abstract

Purpose: We wanted to retrospectively evaluate the CT findings after balloon occluded retrograde transvenous obliteration (BRTO) to determine whether the CT findings can predict varix recurrence. Materials and Methods: Of the 48 patients with gastric varix that was bleeding successfully treated with BRTO between February 2004 and November 2008, 35 of them who underwent follow-up endoscopy and CT were enrolled in this study. The morphologic changes of the gastric varix, including gastrorenal shunt and an afferent vein, were evaluated with the use of CT. Results: Gastric varix recurred in 4 patients and rebleeding occurred in 2. In 22 of 25 patients who underwent CT within 6 months, complete thrombosis of the gastric varix filled with lipiodol was noted, and the gastric varix disappeared without recurrence in all the patients during the long term follow up period. In the other 3patients who only had thrombosis without lipiodol in the gastric varix, the gastric varices recurred (p=0.0001). Conclusion: The existence of lipiodol, as seen on CT within 6 months after BRTO, was useful to predict complete obliteration of gastric varices without recurrence during the long term follow up period.

목적: 위정맥류 출혈에 의한 역행성경정맥위정맥류폐색술(Balloon occluded retrograde transvenous obliteration, 이하 BRTO) 후 전산화단층촬영(CT) 소견을 후향적으로 분석하여 위정맥류 재발의 예측이 가능한지 여부를 알아보고자 하였다. 대상과 방법: 2004년 2월부터 2008년 11월까지 위정맥류 출혈로 성공적으로 BRTO를 시행한 48명의 환자 중 CT와 내시경을 통한 추적 검사가 이루어진 35명을 대상으로 위정맥류, 위신단락, 좌측위정맥과 후위정맥 등의 변화를 CT를 통해 분석하였다. 결과: 위정맥류 재발은 4명에서 발생하였고 2명에서는 재출혈을 보였다. 6개월 이내에 CT를 시행한 25명의 환자 중 22명에서 위정맥류 내에 치밀한 리피오돌 섭취가 보였으며 장기 추적검사에서 재발은 없었고, 리피오돌 섭취 없이 단순 혈전만 관찰된 3명에서는 위정맥류 재발이 관찰되었다(p=0.0001). 결론: 6개월 이내에 시행한 CT에서 위정맥류 내에 리피오돌의 존재는 장기 추적기간 동안 재발없이 위정맥류의 완전 소실을 예측하는데 유용하였다.

Keywords

References

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