Reduced conscious blood flow in the stomach during non-steroidal anti-inflammatory drugs administration assessed by flash echo imaging

Abstract

Objective. Harmonic flash echo imaging, which is an intermittent second harmonic imaging technique, has recently been developed for the evaluation of blood flow. The present study was designed to investigate human gastric blood flow during administration of non-steroidal anti-inflammatory drugs (NSAIDs) by harmonic flash echo imaging. Material and methods. Eight healthy volunteers were enrolled in the study. After an overnight fast, the volunteers were requested to drink 400 ml water and remain in the sitting position. Seven milliliters (300 mg/ml) Levovist® (SHU508A) was then injected intravenously at the rate of 1 ml/s, and intermittent harmonic scanning was carried out at 1-s intervals. A similar examination was carried out one hour after each subject took an oral tablet of diclofenac sodium (50 mg). To minimize the effect of variations in acoustic attenuation among patients, the ratio of the maximum amplitude in the gastric wall to that in the portal vein was expressed as the gastric perfusion index. Results. Strong ultrasonographic contrast enhancement of the gastric wall and portal vein was observed. The area under the curve was significantly reduced in the images obtained after ingestion of the diclofenac sodium tablet. The gastric perfusion index was significantly reduced from 0.617±0.114 to 0.480±0.127 in the antrum and from 0.659±0.103 to 0.509±0.107 in the lower gastric corpus after ingestion of the diclofenac sodium tablet (p<0.05). Conclusions. A reduction in the human conscious gastric transmural blood flow following ingestion of an NSAID is revealed by harmonic flash echo imaging.