MR angiography of esophageal mural veins in portal hypertension: a correlation with endoscopic grades of esophageal varices

Abstract

One of the most important clinical outcomes of portosystemic collateral formation is esophageal varices. Approximately half of the cirrhotic patients have esophageal varices at the time of diagnosis. Incidence of varices may increase to 90% in the long-term follow-up of the cases (1). Grade 3 and 4 varices have particular importance since they can cause life-threatening upper gastrointestinal hemorrhage. The gold standard method in the identification of esophageal varices is upper gastrointestinal endoscopy. However, this method is invasive. Although the noninvasive testing of portal hypertension (PHT) such as blood chemistry and sonographic assessment of splenic size Turk J Gastroenterol 2010; 21 (3): 275-279

Non-invasive ultrasound-based diagnosis and staging of esophageal varices in liver cirrhosis. A systematic review of the literature published in the third Millenium

“…In the end, after exclusion of duplicates and application of all inclusion and exclusion criteria, there were 11 papers that studied the role of ultrasound-based procedures (gray-scale and Doppler abdominal US) and two further articles that evaluated the role of liver rigidity in the prediction, evaluation and risk of rupture of EV (table I). The papers referring to the role of CT (1 paper [17]) or MRI (3 papers [18][19][20]) were not included in the study because they were retrospective and included patients that were already receiveing medical treatment with beta-blocking agents. There was one paper which evaluated the role of spleen rigidity in the surveilance of EV [21] but it was excluded from our study because it reported on patients with previous episodes of upper-GI bleeding in their history or patients treated with beta-blocking agents, parameters defined as exclusion criteria for our study.…”

Contribution of magnetic resonance imaging to the management of esophageal diseases: A systematic review

“…One study evaluated oesophageal mural veins and paraesophageal veins by MR portography in patients with portal hypertension. The authors included 57 patients, with endoscopically documented esophageal varices and found a significant correlation between the diameter of the esophageal mural veins assessed by MR angiography and the endoscopic grade of the esophageal varices (r=0.363; p=0.02) (65). However, no other team has reproduced these results ever since.…”