Visualization and hypervascularization of the haemorrhoidal plexus in vivo using power Doppler imaging transanal ultrasonography and three‐dimensional power Doppler angiography. (November 2013)

• Record Type: Journal Article
• Authors: Miyamoto, H.; Asanoma, M.; Miyamoto, H.; Takasu, C.; Masamune, K.; Shimada, M.
• Is Part Of: Colorectal disease. Volume 15:Number 11(2013)
• Page Start: e686
• Page End: e691
• Publication Date: 2013-11
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12406
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12406-abs-0001"> <title>Abstract</title> <sec id="codi12406-sec-0001" sec-type="section"> <title>Aim</title> <p>The purpose of this study was to demonstrate the distribution of haemorrhoidal arteries and the relationship between vascularity and growth of haemorrhoids.</p> </sec> <sec id="codi12406-sec-0002" sec-type="section"> <title>Method</title> <p>One‐hundred and three patients with haemorrhoids were studied. Using power Doppler imaging (PDI) transanal ultrasound and three‐dimensional power Doppler angiography (3D‐PDA), the course of the arteries supplying the haemorrhoids was identified. Measurement of the PDI area was made using the cursor to outline the power Doppler signal of the haemorrhoid, approximately 1 cm above the dentate line.</p> </sec> <sec id="codi12406-sec-0003" sec-type="section"> <title>Results</title> <p>The haemorrhoidal arteries were seen as branches of the superior rectal artery and were detected in 75.7, 71.8, 68.0 and 62.1% of the 11, 7, 3 and 1 o'clock positions in the lithotomy position. The median number of haemorrhoidal arteries significantly increased from three to six with progression of the Goligher classification from Grade 1 to Grade 4 (<italic>P</italic> < 0.0001). The PDI areas in Grades 1, 2, 3 and 4 were 0.04 ± 0.03, 0.18 ± 0.07, 0.38 ± 0.18 and 0.96 ± 0.32 cm<sup>2</sup> (<italic>P</italic> < 0.05).</p> </sec> <sec id="codi12406-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The distribution of haemorrhoidal arteries varies widely in both number and position. Using PDI transanal ultrasonography and 3D‐PDA it was possible to visualize the haemorrhoid plexus and the course of the haemorrhoidal artery <italic>in vivo</italic>.</p> </sec> </abstract>