Value of multi-slice spiral CT portal venography in prediction of esophagogastric variceal bleeding

Abstract

To assess the clinical value of multi-slice spiral CT portal venography in prediction of esophagogastric variceal bleeding. The relation was detected between esophagogastric variceal bleeding and the location of left gastric vein orifice on portal system. Also the correlation was studied between the severity of esophageal varices endoscopically and the diameter of portal vein with multi-slice spiral CT portal venography. Sixty-nine patients with esophagogastric varices confirmed by both endoscopy and 16-detector row CT portal venography due to cirrhosis were enrolled. Excellent image quality of portal collateral vessels with CTPV was obtained in all patients. The portal and left gastric veins were visualized both with CTPV 69/69 (100%). Esophageal and gastric varices were visualized with CTPV 62/69 (89.9%) and 50/69 (72.5%) respectively. The left gastric vein orifice was located on the portal vein in 42 cases. There was correlation between esophagogastric variceal hemorrhage and the location of left gastric vein orifice (Chi(2) = 4.406, P < 0.05). But no relation was found between the severity of esophageal varices and the diameter of portal vein (P > 0.05). CTPV can not only provide important and accurate information of collateral circulation in patients with portal hypertension, but also measure the diameter of collateral blood vessel. There is a higher probability of esophagogastric variceal bleeding for the patients with left gastric vein orifice on portal vein. The combined approaches of CTPV and endoscopy can not only diagnose the severity of esophagogastric varices, but also predict the risk of esophagogastric variceal bleeding.