CT portography using MDCT versus color doppler in detection of varices in cirrhotic patients
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 402-408
AbstractBackground: All chronic liver diseases end with cirrhosis. Upper gastrointestinal tract
hemorrhage brought on by the formation of esophageal varices is the most frequent
cause of death in cirrhotic individuals. It will be possible to prevent potential difficulties
during interventional procedures and surgery if portosystemic collaterals are diagnosed
using non-invasive approaches.
Materials and Methods: A cross-sectional study involving 90 patients who were
diagnosed with liver cirrhosis based on symptoms and test results and presented to the
medical gastroenterology department. To best display portal venous architecture,
disease, and venous collaterals, Color Doppler US was first done using the Philips Epiq
7G machine. The transducer and gain settings were changed in each instance. The work
station was used to obtain portography pictures while the 256 Slice Phillips (Brilliance)
was used to do CT. All of the patients underwent endoscopy, and the results were
compared using the Pearson's Coefficient test to those obtained from USG and CT.
Results: Of the 90 patients, 26, 14, 38, and 12 had esophageal varices of Grades I–III
and none at all. Grade I and II varices were not found in USG, however 8/12 Grade III
varices were. All 38 cases of grade II varices and 12 cases of grade III varices were
found using CT. For the diagnosis of paraesophageal, splenorenal, anterior abdominal
wall, peri-umbilical, and peri-cholecystic collaterals, USG and CT showed excellent
agreement (Kappa values >0.7). There was no agreement between USG and CT for the
detection of esophageal, gastric mucosal, perigastric, and retroperitoneal collaterals.
Conclusion: Grade III varices are found by USG, while Grade II and III varices are
found by CT. Compared to USG, CT is more effective at delineating all portosystemic
collaterals. When defining intricate collateral routes, USG is less accurate than MDCT
portal venous phase. In order to identify unanticipated varices that could cause
considerable bleeding during liver transplant procedures, multislice CT can be used to
detect potentially problematic varices by tracing the path of tortuous veins.
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