Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage?
<i>Background and objectives:</i> Variceal bleeding is a serious complication caused by portal hypertension, frequently encountered among cirrhotic patients. The purpose of this study was to determine whether the aspect of the collateral, porto-systemic circulation, as detected by CT are...
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MDPI AG
2020-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/6/301 |
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| author | Cosmin Caraiani Bianca Petresc Anamaria Pop Magda Rotaru Lidia Ciobanu Horia Ștefănescu |
| author_facet | Cosmin Caraiani Bianca Petresc Anamaria Pop Magda Rotaru Lidia Ciobanu Horia Ștefănescu |
| author_sort | Cosmin Caraiani |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Variceal bleeding is a serious complication caused by portal hypertension, frequently encountered among cirrhotic patients. The purpose of this study was to determine whether the aspect of the collateral, porto-systemic circulation, as detected by CT are associated with the presence variceal hemorrhage (VH). <i>Materials and Methods:</i> 81 cirrhotic patients who underwent a contrast-enhanced CT examination were retrospectively included in the study. Patients were divided into two groups: Cirrhotic patients with variceal hemorrhage during the hospital admission concomitant, with the CT examination (<i>n</i> = 33) and group 2-cirrhotic patients, without any variceal hemorrhage in their medical history (<i>n</i> = 48). The diameter of the left gastric vein, the presence or absence and dimensions of oesophageal and gastric varices, paraumbilical veins and splenorenal shunts were the indicators assessed on CT. <i>Results:</i> The univariate analysis showed a significant association between the presence of upper GI bleeding and the diameters of paraoesophageal veins, paragastric veins and left gastric vein respectively, all of these CT parameters being higher in patients with variceal bleeding. In the multivariate logistic regression analysis, only the diameter of the left gastric vein was independently associated with the presence of variceal hemorrhage (OR = 1.6 (95% CI: 1.17–2.19), <i>p</i> = 0.003). We found an optimal cut-off value of 3 mm for the diameter of the left gastric vein useful to discriminate among patients with variceal hemorrhage from the ones without it, with a good diagnostic performance (AUC = 0.78, Se = 97%, Sp = 45.8%, PPV = 55.2%, NPV = 95.7%).<i>Conclusions:</i> Our observations point out that an objective CT quantification of porto-systemic circulation can be correlated with the presence of variceal hemorrhage and the diameter of the left gastric vein can be a reliable parameter associated with this condition. |
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| language | English |
| last_indexed | 2024-03-12T06:03:39Z |
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| spelling | doaj.art-52aa381b885a4f0e8472eb20a4d42d8f2023-09-03T03:49:41ZengMDPI AGMedicina1010-660X2020-06-015630130110.3390/medicina56060301Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage?Cosmin Caraiani0Bianca Petresc1Anamaria Pop2Magda Rotaru3Lidia Ciobanu4Horia Ștefănescu5Department of Medical Imaging, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, RomaniaDepartment of Radiology, Emergency Clinical County Hospital Cluj-Napoca, 400006 Cluj-Napoca, RomaniaDepartment of Gastroenterology and Digestive Endoscopy, Medical Center of Gastroenterology, Hepatology and Digestive Endoscopy, 400132 Cluj-Napoca, RomaniaDepartment of Internal Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, RomaniaDepartment of Gastroenterology and Hepatology, Regional Institute of Gastroenterology and Hepatology “Prof. Dr Octavian Fodor”, 400158 Cluj-Napoca, RomaniaDepartment of Gastroenterology and Hepatology, Regional Institute of Gastroenterology and Hepatology “Prof. Dr Octavian Fodor”, 400158 Cluj-Napoca, Romania<i>Background and objectives:</i> Variceal bleeding is a serious complication caused by portal hypertension, frequently encountered among cirrhotic patients. The purpose of this study was to determine whether the aspect of the collateral, porto-systemic circulation, as detected by CT are associated with the presence variceal hemorrhage (VH). <i>Materials and Methods:</i> 81 cirrhotic patients who underwent a contrast-enhanced CT examination were retrospectively included in the study. Patients were divided into two groups: Cirrhotic patients with variceal hemorrhage during the hospital admission concomitant, with the CT examination (<i>n</i> = 33) and group 2-cirrhotic patients, without any variceal hemorrhage in their medical history (<i>n</i> = 48). The diameter of the left gastric vein, the presence or absence and dimensions of oesophageal and gastric varices, paraumbilical veins and splenorenal shunts were the indicators assessed on CT. <i>Results:</i> The univariate analysis showed a significant association between the presence of upper GI bleeding and the diameters of paraoesophageal veins, paragastric veins and left gastric vein respectively, all of these CT parameters being higher in patients with variceal bleeding. In the multivariate logistic regression analysis, only the diameter of the left gastric vein was independently associated with the presence of variceal hemorrhage (OR = 1.6 (95% CI: 1.17–2.19), <i>p</i> = 0.003). We found an optimal cut-off value of 3 mm for the diameter of the left gastric vein useful to discriminate among patients with variceal hemorrhage from the ones without it, with a good diagnostic performance (AUC = 0.78, Se = 97%, Sp = 45.8%, PPV = 55.2%, NPV = 95.7%).<i>Conclusions:</i> Our observations point out that an objective CT quantification of porto-systemic circulation can be correlated with the presence of variceal hemorrhage and the diameter of the left gastric vein can be a reliable parameter associated with this condition.https://www.mdpi.com/1010-660X/56/6/301cirrhosisportal hypertensionvariceal hemorrhageCT scanporto-systemic circulationoesophageal varices |
| spellingShingle | Cosmin Caraiani Bianca Petresc Anamaria Pop Magda Rotaru Lidia Ciobanu Horia Ștefănescu Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? Medicina cirrhosis portal hypertension variceal hemorrhage CT scan porto-systemic circulation oesophageal varices |
| title | Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? |
| title_full | Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? |
| title_fullStr | Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? |
| title_full_unstemmed | Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? |
| title_short | Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients be Associated with the Presence of Variceal Hemorrhage? |
| title_sort | can the computed tomographic aspect of porto systemic circulation in cirrhotic patients be associated with the presence of variceal hemorrhage |
| topic | cirrhosis portal hypertension variceal hemorrhage CT scan porto-systemic circulation oesophageal varices |
| url | https://www.mdpi.com/1010-660X/56/6/301 |
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