Purpose : The purpose of our study was to determine the diagnostic accuracy of
duplex Doppler US in detecting high-grade stenosis or occlusion of splanchnic arteries
and to validate the previously reported duplex Doppler US criteria using a fasting PSV.
Materials and Methods : Over a recent 3-year, 82 patients were evaluated with duplex
Doppler US. Among 82 patients, two were excluded due to nondiagnostic examination.
Thus this study included 80. All patients were examined after an overnight fast. The
results of Doppler US examinations were compared with angiography.
Results : The spectral waveforms from CA and SMA, suitable for a measurement of
peak systolic velocity, were obtained in 80(98%) of 82 patients. Lateral aortograms
revealed 12 patients with CA stenosis(n=7) greater than 70% or CA occlusion(n=5).
Duplex Doppler US detected all 12 cases of CA stenosis or occlusion. No false-negative
was found. Among 68 patients with less than 70% angiographic stenosis, diagnosis of
Doppler US was correct in 59 and there were nine false-positive cases. Among 80
patients, 14 had SMA stenosis (n=9) greater than 70% or SMA occlusion(n=5) on lateral
aortogram. Duplex Doppler US made a correct diagnosis in all 14% patients with SMA
stenosis or occlusion. No false-negative diagnosis was made in 66 patients with less
than 70% angiographic stenosis, duplex Doppler US was correct in 65 and there was
only one false-positive diagnosis.
Conclusion : We believe that duplex Doppler US examination, due to high diagnostic
accuracy, may be helpful in determining the need of conventional angiography in
patients with symptoms suggestive of CII. Our data indicate that a fasting PSV is an
accurate predictor of high-grade splanchnic artery stenosis and duplex Doppler US can
be an useful noninvasive test for the detection of high-grade splanchnic artery stenosis
or occlusion, when the examinations were performed by experienced examiners.
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