Abstract
The purpose of this study was to clarify the mechanism of “diffuse A-V shunts” that occur in the spleen. The subjects were 204 patients with chronic liver disease (13 of whom were positive for diffuse A-V shunts in the spleen) and 108 patients with non-chronic liver disease. The method used was to examine the relationship between splenomegaly and peripheral vascular resistance (RI) and blood flow velocity of the splenic peripheral artery observed using Doppler ultrasound. As a result, ①there was a positive correlation between peripheral arterial blood flow velocity in the spleen and the degree of splenomegaly regardless of the presence or absence of chronic liver disease (rs＝.480, rs＝.471 respectively). ②There was no correlation between splenic peripheral arterial RI and degrees of splenomegaly in non-chronic liver disease, but a positive correlation (rs＝.528) was observed in chronic liver disease. Splenomegaly in non-chronic liver disease is considered to be an “active” state of increased splenic arterial blood flow that requires blood, whereas chronic liver disease is considered to be a “passive” state of increased splenic arterial blood flow. ③The RI of the splenic peripheral artery was high in patients with chronic liver disease in whom splenic “diffuse A-V shunt” was observed. Thus, this phenomenon tended to be observed in more “passive” conditions of splenic artery hyperperfusion. This phenomenon is thought to occur when the limits of peripheral parenchymal perfusion capacity are exceeded.
