CT-maximum intensity projection is a clinically useful modality for the detection of gastric varices

Ishikawa, Toru; Ushiki, Takashi; Mizuno, Ken‐ichi; Togashi, Tadayuki; Watanabe, Kouji; Seki, Keiichi; Ohta, H; Yoshida, Toshiaki; Takeda, Keiko; Kamimura, Tomoteru

doi:10.3748/wjg.v11.i47.7515

Cited by 25 publications

(14 citation statements)

References 10 publications

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“…We found also the availability of precise MIP in sagittal and coronal planes raise the diagnostic performance in visualization of gastric varices, esophageal varices as well as visualization of other portosystemic collaterals and this was also reported by Nakayama et al [28].and Ishikawa et al [29].…”

Section: Discussion:-supporting

confidence: 63%

Large Silent Gastric Fundal Varices in Cirrhotic Patients: Role of Abdominal Multidetector Triphasic Computed Tomography.

MD¹,

MD²

2016

IJAR

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Background:-Gastric varices have been recognized as a major cause of gastrointestinal bleeding, reaching 33% in patients with portal hypertension mostly secondary to liver cirrhosis. Compared with esophageal variceal bleeding, haemorrhage caused by fundal varices, although less frequent, is more severe and haemostatic control is more difficult. The diagnosis and treatment of gastrointestinal bleeding are based mainly on endoscopic examinations however; radiological studies such as computed tomography (CT) studies have proved useful in clinical practice. Spiral imaging has dramatically improved CT in the evaluation of focal hepatic lesion. The aim of this study is to investigate the role of abdominal Multidetector triphasic CT scan done for early detection of hepatocellular carcinoma (HCC) as a predictor and diagnostic tool for silent large gastric fundal varices in patients with liver cirrhosis. Methods:-A total of 145 patients were enrolled in this study. All patients were referred for early detection of HCC with suspected focal hepatic lesion or elevated α fetoprotein above 50 and below 400 IU/dl. All patients underwent full clinical and laboratory investigations. Abdominal US was performed for all patients. Abdominal Multidetector triphasic CT scan was done by a single experienced radiologist for evaluation for the presence of hypervascular focal hepatic lesions, splenomegaly, epigastric and hilar collaterals, portal vein thrombosis and the presence of esophageal or gastric fundal varices. All patients underwent standard upper GIT endoscopy and according to the endoscopic findings the studied patients were further classified to three groups: group I (GI) 79 patients (54.48%) with no or small esophageal and/or gastric varices, group II (GII) 42 patients (28.97%) with large esophageal varices, and group III (GIII) 24 patients (16.55%) with large gastric fundal varices Results:-There was a statistically significant increase in portal vein diameter, splenic size (long axis span), splenic vein diameter, presence of gastro-renal collaterals, portal vein thrombosis and HCC in patients with large gastric fundal varices in relation to other groups. platelet/splenic ratio as calculated by dividing platelet count over long axis of the spleen was determined for each patient which had significant lower values in relation to presence of large gastric varicesStep-wise regression analysis was done for all the above mentioned variables revealing that only three predictors namely the presence of large fundal varices by abdominal CT, presence of splenic hilar or splenorenal collaterals and platelet/splenic ratio were found to have highly significant independent ISSN 2320-5407

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Section: Discussion:-supporting

confidence: 63%

Large Silent Gastric Fundal Varices in Cirrhotic Patients: Role of Abdominal Multidetector Triphasic Computed Tomography.

MD¹,

MD²

2016

IJAR

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“…The ability to view only the brightest pixels helps to define smaller structures. This post processing technique has been used to identify vascular structures, pulmonary nodules, and ureteral stones in people and dogs, and is reported to improve abnormality detection rates as compared to axial source images alone . In addition, MIP images have been shown to provide greater reader confidence in detection of pulmonary nodules in a canine model .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Transverse Computed Tomographic Excretory Urography Images and Maximum Intensity Projection Images for Diagnosing Ectopic Ureters in Dogs

Secrest

Waller

Jiménez

2016

Vet Radiology Ultrasound

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Computed tomographic maximum intensity projection (MIP) images have been shown to improve reader confidence in their diagnoses and to improve detection of vascular structures and pulmonary nodules. The objectives of this method comparison study were to compare transverse source computed tomographic excretory urography (CTEU) images to two, five, and 10 slab thick MIP images for diagnosing canine ectopic ureters, compare reader confidence, and evaluate interobserver agreement. Two board-certified veterinary radiologists and a board-certified small animal internist blindly reviewed transverse source CTEU and two, five, and 10 slab thick MIP images of 24 dogs enrolled in the study. Inclusion criteria included a diagnostic CTEU and either cystoscopic or surgical confirmation of the presence or absence of ureteral ectopia. Eleven dogs were confirmed to have 17 ectopic ureters at surgery and/or cystoscopically. There was no significant difference in reader diagnoses between viewing methods or between viewing methods and the surgical/cystoscopic findings (P < 0.001). Reader confidence was significantly greater on two (P = 0.0080) and five (P = 0.0009) slab thick MIP images with significant interobserver agreement between readers for all viewing methods (P values ranging between 0.0363 and <0.001). In addition, the diagnostic accuracy of MIP images was similar to or better than transverse source CTEU images, when assessed by a radiologist. The study results suggest that CTEU is a reliable imaging technique for diagnosing canine ectopic ureters among specialists of varied experience. In addition, thin slice reconstructed MIP images improve reader confidence and potentially diagnostic accuracy, and thus their use should be considered, especially in more challenging cases.

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“…Reports about incidence of visualization PGV, SGV, and LGEV on CTA (volume rendering) in normal or gastric cancer patients were unfound; more reports of these veins on CT were about gastroesophageal varices. 17,18 The PGVs and SGVs were visible in 92.3% and 96.2% of the patients, respectively, in this study. Although SGVs had high display rate on CTA, the range and median number were less than the autoptic results reported by Ashton et al 19 The possible reasons may be different methods for detecting veins between CTA and autopsy.…”

Section: Discussionmentioning

confidence: 76%

Sixty-Four–Slice Computed Tomography Angiography of Perigastric Veins With Image Fusion

Chu²,

Sun³

et al. 2013

Journal of Computer Assisted Tomography

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CT-maximum intensity projection is a clinically useful modality for the detection of gastric varices

Abstract: We suggest that CT-MIP should be considered as a routine method for detecting and diagnosing collateral veins in patients with gastric varices scheduled for B-RTO. Furthermore, CT-MIP is more useful than endoscopy in verifying the early therapeutic effects of B-RTO.

Cited by 25 publications

References 10 publications

Large Silent Gastric Fundal Varices in Cirrhotic Patients: Role of Abdominal Multidetector Triphasic Computed Tomography.

Large Silent Gastric Fundal Varices in Cirrhotic Patients: Role of Abdominal Multidetector Triphasic Computed Tomography.

Comparison of Transverse Computed Tomographic Excretory Urography Images and Maximum Intensity Projection Images for Diagnosing Ectopic Ureters in Dogs

Sixty-Four–Slice Computed Tomography Angiography of Perigastric Veins With Image Fusion

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