MR angiographyが食道静脈瘤硬化療法の予後判定に有用であった2例

MR Angiography Evaluation of the Therapeutic Response and the Prognosis of Esophageal Varices after Endoscopic Injection Sclerotherapy, Report of Two Cases

要旨　MR angiographyが内視鏡的食道静脈瘤硬化療法の予後の推定に有用であった2症例を経験したので報告する．〔症例1〕は73歳，男性．硬化療法後，内視鏡的には食道静脈瘤は消失したが，MR angiographyでは食道静脈瘤およびその供血路である左胃静脈の血流信号が共に残存しており，治療7週後に食道静脈瘤の再発をみた．〔症例2〕は70歳，男性．硬化療法後，内視鏡・MR angiographyともに食道静脈瘤は消失したが，MR angiographyで左胃静脈の血流信号の残存が認められ，治療9か月後に食道静脈瘤の再発をみた．硬化療法後にMR angiographyで食道静脈瘤あるいは左胃静脈の血流が残存している場合は，再発が危惧されると考えられた．

　MR angiography (two-dimension time-of-flight) was useful for evaluating the therapeutic response and the prognosis of esophageal varices in two cirrhotic patients. Endoscopic injection sclerotherapy showed complete eradication of varices endoscopically in two cases. However, in the first case, MR angiography revealed the persistence of esophageal varices and the left gastric vein. The varices recurred seven weeks after sclero therapy on follow-up endoscopy. In the second case, MR angiography showed the disappearance of the varices and the persistence of the left gastric vein. The varices recurred nine months after sclerotherapy. It can be said that MR angiography is a better predictor of the prognosis of esophageal varices than endoscopy.