Background: Cirrhosis is often complicated by esophageal varices (EVs). The use of upper GI endoscopy (EGD) 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. It is also better tolerated by patients than EGD.
Aim of the work: To assess the efficacy of MDCT in evaluating the EVs.

Patients and method: A prospective cross-sectional study was carried out. in the hepatogastroenterology and infectious disease department and department of radiology, Al-Azhar university hospitals. From June 2021 to November 2021, fifty patients attended the outpatient clinic who had cirrhosis due to chronic HCV were enrolled in the study on a prospective basis, aged 24 to 73 years old. The studied patients were subjected to history taking, clinical examination, MDCT, and EGD.

Results: The cases were separated into three groups based on the CT findings: group I, which included 11 patients with no EVs (22%), group II, which included 11 patients with low-risk varices (22%), and group III, which included 28 patients with high-risk varices (56%). The total CT sensitivity for detecting EVs was 92.8%, with 100% specificity, 100% PPV, and a 72.7% NPV. The MDCT sensitivity for high-risk EVs cases (100%) was greater than that for low-risk EVs cases (72.7%).

Conclusion: MDCT is an excellent diagnostic alternative to conventional EGD for detecting and grading EVs in cirrhotic patients.