Quantitative measurements of esophageal varices using computed tomography for prediction of severe varices and the risk of bleeding: a preliminary study

Abstract

Background We aimed to assess whether the quantitative parameters of esophageal varices (EV) based on computed tomography (CT) can noninvasively predict severe EV and the risk of esophageal variceal bleeding (EVB). Methods A total of 136 endoscopically confirmed EV patients were included in this retrospective study and were divided into a non-conspicuous (mild-to-moderate EV, n = 30) and a conspicuous EV group (severe EV, n = 106), a bleeding (n = 89) and a non-bleeding group (n = 47). EV grade (EVG), EV diameter (EVD), cross-sectional surface area (CSA), EV volume (EVV), spleen volume (SV), splenic vein (SNV), portal vein (PV), diameter of left gastric vein (DLGV), and the opening type of LGV were measured independently using 3D-slicer. Univariate and multivariate logistic analysis were used to determine the independent factors and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic performance. Results The difference of EVG, EVD, CSA, EVV, DLGV, SNV between the conspicuous and non-conspicuous EV group were statistically significant (p < 0.05), area under the curves (AUCs) of them for predicting severe EV were 0.72, 0.772, 0.704, 0.768, 0.707, 0.65, with corresponding sensitivities of 70.3%, 63.5%, 50%, 74.3%, 52.7%, 48.6%, specificities of 71.4%, 85.7%, 100%, 71.4%, 81%, 81%, respectively. EVG, CSA (odds ratio 3.258, 95% CI 1.597–6.647; 1.029, 95% CI 1.008–1.050) were found to be independent predictive factors. However, there was no significant difference of the included indices between the bleeding and non-bleeding group (p > 0.05). Conclusions CT can be used as a noninvasive method to predict the severity of EV, which may reduce the invasive screening of endoscopy.

Precirrhotic Primary Biliary Cholangitis with Portal Hypertension: Bile Duct Injury Correlate

“…7,10 Related studies have proved that varicose veins can be evaluated by imaging examination, and it has high sensitivity and specificity, which can be used in the diagnosis of PH. [22][23][24][25][26][27] By means of imaging examination, the method of defining PH is more comprehensive according to the diagnostic criteria of specificity and non-specificity. This is a retrospective study analyzed a large number of patients with PBC and is the first study to focus on combined PH in patients with simple precirrhotic stage PBC from multiple perspectives.…”

Computed tomography virtual oesophagography for the grading of oesophageal varices in cirrhotic liver disease patients with upper gastrointestinal endoscopic examination as the gold standard: a diagnostic validation study

“…These markers are indirect indicators of deranged portal circulation and may predict future risk. Hence, haemodynamic evaluation as a whole is an advantage of CT over endoscopy [ 16 , 17 ].…”