A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients
Abstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challengin...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-01-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-019-0117-5 |
| _version_ | 1818382767169208320 |
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| author | Hany El-Assaly Lamiaa I. A. Metwally Heba Azzam Mohamed Ibrahim Seif-Elnasr |
| author_facet | Hany El-Assaly Lamiaa I. A. Metwally Heba Azzam Mohamed Ibrahim Seif-Elnasr |
| author_sort | Hany El-Assaly |
| collection | DOAJ |
| description | Abstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challenging varices by detailing the course of these tortuous vessels. This information is decisive for liver transplantation as well as for common procedures in which an unexpected varix can cause significant bleeding. Results This study included an assessment of 60 cases of portal hypertension (28 males and 32 females), their age ranged from 42 to 69 years (mean age = 57.2 ± 6.63). All patients were diagnosed with portal hypertension, underwent upper GI endoscopy followed by a triphasic CT scan with CT angiographic assessment for the screening of gastro-esophageal varices. CT is highly sensitive as compared to upper GI endoscopy (sensitivity 93%) in detecting esophageal varices. Gastric varices detected by CT in 22 patients (37%) compared to 14 patients (23%) detected by endoscopy. While paraesophageal varices were detected in 63% of patients and retro-gastric varices in 80% of patients that were not visualized by endoscopy. Our study reported that the commonest type of collaterals were the splenic collaterals, and we also found there is a significant correlation between the portal vein diameter and the number of collaterals as well as between the portal vein diameter and splenic vein diameter. Conclusions Multi-slice CT serves as an important non-invasive imaging modality in the diagnosis of collaterals in cases of portal hypertension. CT portography can replace endoscopy in the detection of high-risk varices. It also proved that there is a correlation between portal vein diameter, splenic vein diameter, and number of collaterals. |
| first_indexed | 2024-12-14T02:55:42Z |
| format | Article |
| id | doaj.art-4d355e56161a4d53ac5611a5fad62c1c |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-14T02:55:42Z |
| publishDate | 2020-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-4d355e56161a4d53ac5611a5fad62c1c2022-12-21T23:19:38ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622020-01-0151111010.1186/s43055-019-0117-5A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patientsHany El-Assaly0Lamiaa I. A. Metwally1Heba Azzam2Mohamed Ibrahim Seif-Elnasr3Diagnostic and Interventional Radiology, Cairo UniversityDiagnostic and Interventional Radiology, Cairo UniversityDiagnostic and Interventional Radiology, Cairo UniversityTropical Medicine, Cairo UniversityAbstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challenging varices by detailing the course of these tortuous vessels. This information is decisive for liver transplantation as well as for common procedures in which an unexpected varix can cause significant bleeding. Results This study included an assessment of 60 cases of portal hypertension (28 males and 32 females), their age ranged from 42 to 69 years (mean age = 57.2 ± 6.63). All patients were diagnosed with portal hypertension, underwent upper GI endoscopy followed by a triphasic CT scan with CT angiographic assessment for the screening of gastro-esophageal varices. CT is highly sensitive as compared to upper GI endoscopy (sensitivity 93%) in detecting esophageal varices. Gastric varices detected by CT in 22 patients (37%) compared to 14 patients (23%) detected by endoscopy. While paraesophageal varices were detected in 63% of patients and retro-gastric varices in 80% of patients that were not visualized by endoscopy. Our study reported that the commonest type of collaterals were the splenic collaterals, and we also found there is a significant correlation between the portal vein diameter and the number of collaterals as well as between the portal vein diameter and splenic vein diameter. Conclusions Multi-slice CT serves as an important non-invasive imaging modality in the diagnosis of collaterals in cases of portal hypertension. CT portography can replace endoscopy in the detection of high-risk varices. It also proved that there is a correlation between portal vein diameter, splenic vein diameter, and number of collaterals.https://doi.org/10.1186/s43055-019-0117-5Portal hypertensionCirrhosisCT portographyEndoscopyVarices |
| spellingShingle | Hany El-Assaly Lamiaa I. A. Metwally Heba Azzam Mohamed Ibrahim Seif-Elnasr A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients The Egyptian Journal of Radiology and Nuclear Medicine Portal hypertension Cirrhosis CT portography Endoscopy Varices |
| title | A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients |
| title_full | A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients |
| title_fullStr | A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients |
| title_full_unstemmed | A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients |
| title_short | A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients |
| title_sort | comparative study of multi detector ct portography versus endoscopy in evaluation of gastro esophageal varices in portal hypertension patients |
| topic | Portal hypertension Cirrhosis CT portography Endoscopy Varices |
| url | https://doi.org/10.1186/s43055-019-0117-5 |
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