MR-IMAGING IN THE EVALUATION OF THE THERAPEUTIC EFFECT OF B-RTO FOR GASTRIC VARICES

BACKGROUNDS/AIMS: Balloon-occluded retrograde transvenous obliteration (B-RTO) has become a new treatment option for gastric varices. In the present study, mid-term follow-up data after B-RTO were presented, an d the role of magnetic resonance imaging (MRI) and MR-portography in t he assessment of therapeutic effect was evaluated. METHODOLOGY: Twelve patients with gastric varices were treated with up to three sessions of B-RTO. The patients were followed up with MRI, MR-portography, and endoscopy for a mean of 12.3 months. RESULTS: In ten patients, one (n= 8) or two (n=2) sessions of B-RTO were effective to produce immediate (<2weeks) variceal obliteration on MRI and MR-portography. Endoscopic confirmation of variceal eradication was obtained within three (n=9) o r six (n=1) months after B-RTO in these patients. The remaining two pa tients who underwent three sessions of B-RTO showed only a significant reduction in variceal size immediately after B-RTO, but variceal obli teration was observed within three months with subsequent variceal era dication. There were no signs of exacerbation of gastric varices on MR I and endoscopy in any patient during the follow-up period. CONCLUSION S: The results suggest that B-RTO is effective for the treatment of ga stric varices. MRI and MR-portography may provide accurate assessment of therapeutic effect.