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118550

Comparative Study of Esophageal Varices Grading by Multi-Detector Computed Tomography and Endoscopy

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Last updated: 22 Jan 2023

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Abstract

Abstract Background: Cirrhosis is often complicated by Esophageal Varices (EV) and portal hypertension. The use of upper GI endoscopy (GIE) as a screening method is limited regarding invasiveness, expensive, needs sedation as well as patient's poor acceptance of the procedure. In contrast; Multidetector Computed Tomography (MDCT) imaging is non-invasive, does not necessitate sedation, and allows accurate assessment of variceal site and size, also better tolerated by patients than upper GI Endoscopy (GIE). Aim of Study: To prove that MDCT is a non-invasive alternative diagnostic tool to EGD in grading of Esophageal Varices. Patients and Methods: 50 patients with liver cirrhosis were included. Evaluation of Multidetector Computed Tom-ography (MDCT) in the diagnosis of esophageal varices and its grading was done by comparing the grades of Esophageal Varices at Multidetector Computed Tomography (MDCT) and upper GI endoscopy independently. Extra-esophageal findings were also assessed by Multidetector Computed Tomography (MDCT) that cannot by (GIE). Results: At upper GI endoscopy, 3 patients had grade 0 Esophageal Varices, 25 patients had grade 1, 16 patients had grade 2 and 6 had grade 3. The sensitivity, specificity, positive and negative predictive values and accuracy of Multidetector Computed Tomography (MDCT) for defining Esophageal Varices in all grades were 99.5%, 99.6%, 99.4%, 99.5% and 99.5% respectively. Important extra-esophageal findings were determined by Multi-Detector Computed Tomography (MD-CT) only. The acceptance of patients for Multidetector Com-puted Tomography (MDCT) was significantly more than that for upper GI Endoscopy (GIE). Conclusion: Multi-Detector Computed Tomography (MD-CT) is a fast, non-invasive procedure for diagnosis and grading of Esophageal Varices.

DOI

10.21608/mjcu.2020.118550

Keywords

Esophageal varices (EV), Upper GI endoscopy (GIE), Computed tomography (CT), Multide-tector Computed Tomography (MDCT), Esopha-go-Gastro-Duodenoscopy (EGD), Intra-Venous (IV)

Authors

First Name

FATMA A. EL-SHARAWY, M.D.;

Last Name

MOHAMED M. MABROUK, M.D.

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Affiliation

The Departments of Radio-Diagnosis & Medical Imaging* and Internal Medicine**, Faculty of Medicine, Tanta University, Egypt

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Volume

88

Article Issue

September

Related Issue

14147

Issue Date

2020-09-01

Receive Date

2020-06-13

Publish Date

2020-09-01

Page Start

1,923

Page End

1,931

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_118550.html

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https://mjcu.journals.ekb.eg/service?article_code=118550

Order

54

Type

Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023