PDF(Pubmed)
Abstract：
BACKGROUND: In Tanzania, triphasic abdominal Computed Tomography (CT) is a more accessible and non-invasive alternative for diagnosing esophageal varices, though its accuracy has not been thoroughly evaluated, therefore this study aimed to determine the diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices using esophagogastroduodenoscopy (OGD) as the gold standard among patients with upper gastrointestinal bleeding at Muhimbili National Hospital (MNH).
METHODS: This cross-sectional study was conducted at MNH from January 2021 to May 2023. We sampled upper gastrointestinal bleeding patients who underwent both OGD and triphasic abdominal CT using non-probability consecutive sampling. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of triphasic abdominal CT were assessed against OGD findings.
RESULTS: In a study of 200 participants, esophageal varices were detected in 54% by OGD and 53.5% by CT. We observed 105 true positives, 2 false positives, 90 true negatives, and 3 false negatives. Triphasic abdominal CT demonstrated a sensitivity of 97.2%, specificity of 97.8%, PPV of 98.1%, NPV of 96.8%, and an accuracy of 97.5%. Extraluminal findings included portal venous thrombosis in (22%), splenic collateral (51.5%), ascites (32%), hepatocellular carcinoma (13%), and periportal fibrosis (32%).
CONCLUSIONS: Triphasic abdominal Computed Tomography can be used as a reliable and non-invasive alternative modality for diagnosing and screening esophageal varices in resource-limited settings.
METHODS: This cross-sectional study was conducted at MNH from January 2021 to May 2023. We sampled upper gastrointestinal bleeding patients who underwent both OGD and triphasic abdominal CT using non-probability consecutive sampling. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of triphasic abdominal CT were assessed against OGD findings.
RESULTS: In a study of 200 participants, esophageal varices were detected in 54% by OGD and 53.5% by CT. We observed 105 true positives, 2 false positives, 90 true negatives, and 3 false negatives. Triphasic abdominal CT demonstrated a sensitivity of 97.2%, specificity of 97.8%, PPV of 98.1%, NPV of 96.8%, and an accuracy of 97.5%. Extraluminal findings included portal venous thrombosis in (22%), splenic collateral (51.5%), ascites (32%), hepatocellular carcinoma (13%), and periportal fibrosis (32%).
CONCLUSIONS: Triphasic abdominal Computed Tomography can be used as a reliable and non-invasive alternative modality for diagnosing and screening esophageal varices in resource-limited settings.
摘要：
背景：在坦桑尼亚，三相腹部计算机断层扫描（CT）是诊断食管静脉曲张的一种更容易且无创的替代方法，尽管它的准确性尚未得到彻底评估，因此,本研究旨在确定在Muhimbili国立医院(MNH)的上消化道出血患者中,以食管胃十二指肠镜(OGD)作为金标准的腹部三相CT检测食管静脉曲张的准确性.
方法：这项横断面研究于2021年1月至2023年5月在MNH进行。我们使用非概率连续采样对同时接受OGD和三相腹部CT的上消化道出血患者进行采样。敏感性,特异性，负预测值(NPV)，阳性预测值(PPV)，并根据OGD结果评估了三相腹部CT的准确性。
结果：在200名参与者的研究中，OGD和CT分别检测到54％和53.5％的食管静脉曲张。我们观察到105个真阳性，2假阳性，90个真正的否定，三个假阴性。腹部三相CT显示灵敏度为97.2％，特异性为97.8%，PPV为98.1%，NPV为96.8%，准确率为97.5%。腔外发现包括门静脉血栓形成（22％），脾抵押品(51.5%)，腹水（32%），肝细胞癌（13%），和门静脉周围纤维化（32%）。
结论：在资源有限的环境中，三相腹部计算机断层扫描可作为诊断和筛查食管静脉曲张的可靠和非侵入性替代方法。
方法：这项横断面研究于2021年1月至2023年5月在MNH进行。我们使用非概率连续采样对同时接受OGD和三相腹部CT的上消化道出血患者进行采样。敏感性,特异性，负预测值(NPV)，阳性预测值(PPV)，并根据OGD结果评估了三相腹部CT的准确性。
结果：在200名参与者的研究中，OGD和CT分别检测到54％和53.5％的食管静脉曲张。我们观察到105个真阳性，2假阳性，90个真正的否定，三个假阴性。腹部三相CT显示灵敏度为97.2％，特异性为97.8%，PPV为98.1%，NPV为96.8%，准确率为97.5%。腔外发现包括门静脉血栓形成（22％），脾抵押品(51.5%)，腹水（32%），肝细胞癌（13%），和门静脉周围纤维化（32%）。
结论：在资源有限的环境中，三相腹部计算机断层扫描可作为诊断和筛查食管静脉曲张的可靠和非侵入性替代方法。
