Application Value Of Enhanced CT Examination In Liver Cirrhosis With Esophageal And Gastric Varices

Objective: The purpose of this paper is to compare the gastroscopy and enhancedCT examination in esophageal and gastric varices diagnosis, to explore the relationshipbetween the degree of esophageal gastric varices under gastroscope and enhanced CTmeasurement of the inner diameter of portal vein and splenic vein, and to evaluate thediagnostic value of enhanced CT examination in liver cirrhosis with esophageal andgastric varices.Methods: A retrospective study of118liver cirrhosis with esophageal and gastricvarices who were clinically diagnosed in the First Affiliated Hospital of DalianMedical University from1.1.2010to1.1.2014. All the patients had the gastroscopyand enhanced CT examination during hospital stay. The analytic content includegeneral data, the degree of esophageal gastric varices, the course of disease, liverfunction, the presence of complications and so on. Diagnosis in esophageal and gastricvarices by gastroscopy and enhanced CT examination was compared. The relationshipbetween the degree of esophageal gastric varices under gastroscope and enhanced CTmeasurement of the inner diameter of portal vein and splenic vein was also explored.Results: Among the118patients,69patients were male and49patients werefemale. The ratio of male and female was1.41:1. This group of patients washospitalized with the ages from29to82years old, average56.26±10.97years old, andmost of the patients were in the ages from50to59years old. There are53patients withonly esophageal varices, and17cases with only gastric varices. There are48patientshave esophageal varices accompanied with gastric varices.The etiologies of liver cirrhosis with esophageal and gastric varices are: chronic hepatitis B in55patients(46.6%); alcoholic liver cirrhosis in21patients(17.8%);autoimmune liver diseases in17patients(14.4%); chronic hepatitis C in9patients(7.6%); hepatitis B combined with alcoholic liver disease in4patients(3.4%);cryptogenic cirrhosis in12patients(17.8%).The state of liver function(Child-Pugh state) is as follows:47patients with gradeA(39.8%)，38patients with grade B (32.2%)，33patients with grade C (28.0%). Thedegree of esophageal gastric varices by gastroscopy is as follows: mild degree in35cases(29.7%), moderate degree in37cases(31.4%), severe degree in46cases (38.9%).The complications is as follows: upper gastrointestinal hemorrhage in27patients(22.9%); hepatic encephalopathy in11patients (9.3%); spontaneous bacterialperitonitis in5patients (4.2%).Gastroscopy is regarded as the golden standard in the diagnosis of esophagealvarices. In118patients with liver cirrhosis combined with esophageal gastric varices,53patients with only esophageal varices were diagnosed by gastroscopy, and48caseswere diagnosed by enhanced CT examination, the CT diagnostic rate is90.57%. Thediagnostic rate between gastroscopy and enhanced CT examination is of no statisticaldifference (P>0.05). Enhanced CT examination and gastroscopy for the diagnosis ofesophageal varices are considered to be highly consistent.In118cases of patients with liver cirrhosis combined with esophageal gastricvarices,17cases with only gastric varices were diagnosed by gastroscopy, and14caseswere diagnosed by enhanced CT examination.The CT diagnostic rate was82.35%. Thediagnostic rate between gastroscopy and enhanced CT examination is of no statisticaldifference (P>0.05). Enhanced CT and gastroscopy examination for the diagnosis ofgastric varices are considered to be highly consistent.In118cases of patients with liver cirrhosis combined with esophageal gastricvarices,48patients with esophageal varices accompanied gastric varices werediagnosed by gastroscopy,43cases were diagnosed by enhanced CT examination, thediagnostic rate was89.58%. The diagnostic rate between gastroscopy and CTexamination is of no statistical difference (P>0.05). Enhanced CT examination andgastroscopy for esophageal varices accompanied gastric varices are considered to behighly consistent.According to gastroscopy,118patients with esophageal gastric varices weredivided into three groups of mild, moderate, severe degree. The inner diameter of portal vein and splenic vein of three groups was measured by CT examination. The portal veininner diameters (mm, x±s) of mild, moderate and severe degree were as follows:12.00±1.20,12.52±1.37and14.03±1.15, respectively.The portal vein inner diameterbetween the three groups were statistically different (P <0.05). Three groups of splenicvein inner diameter (mm, x±s) were as follows:8.33±1.41,9.05±1.27and10.04±1.24, respectively. The splenic vein inner diameter between the three groups werestatistically different (P <0.05). The portal and splenic vein inner diameter weredifferent in patients with different degrees of esophageal and gastric varices, therefore,the size of the portal and splenic vein can be used to reflect the severity of esophagealand gastric varices.Conclusion:1. A highly consistency in the diagnosis of esophageal varices,gastric varices and esophageal varices combined with gastric varices exists betweengastroscopy and enhanced CT examination. Therefore enhanced CT examination is ofimportant value for the diagnosis of esophageal and gastric varices.2. The size of portal and splenic vein measured by enhance CT examination canbe used to primarily judge the severity of esophageal and gastric varices.