The Research For The Correlation Between Left Gastric Vein And Liver Cirrhosis With MSCTA

Objective:To evaluate the anatomy and variation of left gastric vein (LGV) in normal adults with MSCTA and to assess its clinical value.Methods: Totally 234 normal adults underwent 16-slice spiral CT in upper abdominal or whole abdominal. Maximum intensity projection (MIP), volume rendering (VR) and multiplanar reconstruction (MPR) combined with the cross-sectional thin-layer reconstruction were applied for vascular reconstruction of portal vein and the LGV. Normal anatomy and variations of LGV were observed and divided into A, B, C, D groups according to LGV origination. The maximum diameter of the LGV was measured at the point within 2 cm from LGV origination and statistical analysis was made.Results: Of 234 subjects, LGV in 11(4.70%) subjects were not well displayed, and excellent images of LGV were obtained in 223 (95.30%) subjects. The origination included portal vein (46.15%, group A), splenic vein (30.77%, group B), portal splenic angle (14.53%, group C) and the left branch of the portal vein (3.85%, group D), respectively. The maximum diameter of the LGV was (4.74±0.84)mm with 95% confidence interval of 4.63～4.85 mm. There was no statistical difference of maximum diameter of the LGV among the four groups (P>0.05).Conclusion: MSCTA has the ability to clearly show diameter and detailed anatomy of LGV, and can provide normal reference value for clinical diagnosis of LGV. Objective: to quantitative analyze the left gastric vein in normal adult by MSCTA.Methods: Two hundred and thirty four normal adults underwent 16-slice spiral CT in upper abdominal or whole abdominal, 3D post-processing techniques combined with the cross-sectional thin-layer reconstruction were applied for vascular reconstruction of portal vein and the left gastric vein (LGV), the maximum diameter of the left gastric vein was measured within 2cm branch, statistical analysis was finished according to different gender and age group.Results: Two hundred and twenty three subjects received clearly left gastric vein image except for 11 cases.In normal adult males group the largest diameter of the left gastric vein was 4.90±0.85mm, 95% CI 4.75～5.06mm; females group the maximum diameter of the left gastric vein was 4.56±0.80mm, 95% CI 4.40～4.71 mm; the differences of the two groups were statistically significant (P<0.05); comparison among different age groups, comparing 30-39 with>70 year groups and 40-49with >70 year groups there show significantly differences (P<0.05).Conclusion: MSCTA can display LGV clearly and measure its normal diameter accurately, which provides a normal reference range and has very important clinical significance. Objective: To evaluate the relationships between Child-Pugh classif- ication of liver cirrhosis and the diameter of left gastric vein (LGV) and portal vein (PV).Methods: One hundred patients with liver cirrhosis and 200 healthy controls were enhanced scan in upper abdominal with 16-slice spiral CT, multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) images of portal vein and left gastric venous got , measuring the left gastric vein and portal vein diameter and analyzed statistically.Results: The diameters of portal vein and left gastric vein in overall patients with liver cirrhosis compared with the control group were widened (P = 0.00). The largest diameters of the portal vein Child-A and B-class group compared with normal control group and the Child-C level were significantly widened (P<0.05). The maximum diameters of portal vein in Child-C group and the normal control group as well as Child-A and B were no significant difference (P>0.05). The left gastric vein in normal control group, liver cirrhosis without ascites and liver cirrhosis with ascites gradually widened, and the differences were statistically significant (P = 0.00).Conclusions: LGV and PV MSCTA imaging can clearly show the overall anatomical structure and accurately measure the diameter, there is a certain relationship in LGV and PV diameter with liver cirrhosis, but many factors can impact the diameters of LGV and PV, so can not evaluated the level of liver cirrhosis with the diameter size lonely. Objective: To evaluate the clinical value of left gastric vein (LGV)-MSCTA in predicting esophageal variceal bleeding in patient with liver cirrhosis complicated by portal hypertension.Methods:Seventy-four patients with liver cirrhosis and 200 healthy controls were enhanced scan in upper abdominal with 16-slice spiral CT, multi-planar reconstruction (MPR) and maximum intensity projection (MIP) images of left gastric venous were obtained.The left gastric vein and esophageal varices was observed and the maximum diameter of the left gastric vein was measured and analyzed statistically.Results:The maximum diameter of the left gastric vein of portal hypertension group compared with the control group was widened (P = 0.00). The maximum diameter of the left gastric vein of portal hypertensive bleeding group and no bleeding group compared with the control group were widened significantly, the difference was statistically significant (P<0.05). When the maximum diameter of the left gastric vein was 7.0 mm and when we put it as the standard of bleeding,the diagnostic sensitivity, specificity and accuracy rate were 61.5%,77.1% and 71.6% , respectively.Conclusions:MSCTA can clearly show the situation of LGV and esophageal varices; LGV widened is a risk factor for portal hypertension esophageal variceal bleeding. The measurement of left gastric vein has a certain predictive value to the esophageal variceal bleeding.