PDF(Pubmed)
Abstract：
Background and Objectives: Esophageal varices (EV) and variceal hemorrhages are major causes of mortality in liver cirrhosis patients. Detecting EVs early is crucial for effective management. Computed tomography (CT) scans, commonly performed for various liver-related indications, provide an opportunity for non-invasive EV assessment. However, previous CT studies focused on variceal diameter, neglecting the three-dimensional (3D) nature of varices and shunt vessels. This study aims to evaluate the potential of 3D volumetric shunt-vessel measurements from routine CT scans for detecting high-risk esophageal varices in portal hypertension. Methods: 3D volumetric measurements of esophageal varices were conducted using routine CT scans and compared to endoscopic variceal grading. Receiver operating characteristic (ROC) analyses were performed to determine the optimal cutoff value for identifying high-risk varices based on shunt volume. The study included 142 patients who underwent both esophagogastroduodenoscopy (EGD) and contrast-enhanced CT within six months. Results: The study established a cutoff value for identifying high-risk varices. The CT measurements exhibited a significant correlation with endoscopic EV grading (correlation coefficient r = 0.417, p < 0.001). A CT cutoff value of 2060 mm3 for variceal volume showed a sensitivity of 72.1% and a specificity of 65.5% for detecting high-risk varices during endoscopy. Conclusions: This study demonstrates the feasibility of opportunistically measuring variceal volumes from routine CT scans. CT volumetry for assessing EVs may have prognostic value, especially in cirrhosis patients who are not suitable candidates for endoscopy.
摘要：
背景和目的：食管静脉曲张（EV）和静脉曲张出血是肝硬化患者死亡的主要原因。及早发现电动汽车对于有效管理至关重要。计算机断层扫描(CT)扫描,通常用于各种与肝脏相关的适应症，提供非侵入性EV评估的机会。然而,以前的CT研究集中在静脉曲张直径，忽略静脉曲张和分流血管的三维(3D)性质。这项研究旨在评估从常规CT扫描中进行3D容积分流血管测量以检测门脉高压症的高危食管静脉曲张的潜力。方法：使用常规CT扫描进行食管静脉曲张的3D体积测量，并与内镜下静脉曲张分级进行比较。进行了接收器工作特性（ROC）分析，以确定基于分流体积识别高风险静脉曲张的最佳截止值。该研究包括142例患者，他们在六个月内同时接受了食管胃十二指肠镜检查（EGD）和对比增强CT检查。结果：该研究建立了识别高风险静脉曲张的临界值。CT测量结果与内窥镜EV分级显著相关(相关系数r=0.417,p<0.001)。静脉曲张体积的CT截止值为2060mm3，在内窥镜检查过程中检测高风险静脉曲张的敏感性为72.1％，特异性为65.5％。结论：这项研究证明了从常规CT扫描中机会性测量静脉曲张体积的可行性。用于评估电动汽车的CT容积可能具有预后价值，尤其是在不适合进行内窥镜检查的肝硬化患者中。
