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CT portography using mdct versus color Doppler in detection of varices in cirrhotic patient

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Radiodiagnosis

Advisors

Saeid, Ahmad S., El-Azizi, Hatem M.

Authors

Aly, Muhammad Talaat

Accessioned

2017-04-26 12:05:13

Available

2017-04-26 12:05:13

type

M.Sc. Thesis

Abstract

The aim of this study is to evaluate and compare the role of multidetectorcomputed tomography (MDCT) angiography as a recent lessinvasive technique for investigating portosystemic shunts as compared toColor Coded Doppler. This study included 8 demonstrative cases (1normal and 7 cases with portosystemic shunts).Multidetector CT portography provides excellent images in thevisualization of portosystemic collaterals. MDCT angiography is capableof differentiating between submucosal and perigastric fundal variceswhich is of clinical interest. In addition, MDCT angiography allowsidentification of the afferent and efferent veins of oesophageal and gastricvarices.Although color Doppler sonography is a useful, noninvasive modalityfor evaluating the hemodynamics of gastric varices, it falls shortly invisualizing the detailed hemodynamics of the inflowing and outflowingvessels of gastric varices in nearly half of the patients when comparedwith computed tomography.Among the three rendering techniques (VR, MIP and SSD) , MIP(maximum intensity projection) images provide the best visualization ofportal vein and portosystemic collaterals.Although endoscopy is the most reliable diagnostic procedure fordetecting esophageal varices, CT portography is superior to endoscopy invisualization of submucosal fundal gastric varices, peri-oesophageal andperigastric varices. Moreover, 3D CT portography is useful first forselecting patients as candidates for alternative therapeutic strategies suchas balloon occluded retrograde transvenous obliteration (B-RTO) ofgastric varices, second for planning, and third for evaluating theembolization therapy.Color coded Doppler can predict the site, size of varices and its risk ofbleeding according to size, blood velocity and direction of flow of theportal, splenic and left gastric veins. These measurements reflect theseverity of portal hypertension, therefore, we could select patients whoare under risk of bleeding to do further assessment by CT portographyand upper GIT endoscopy to predict bleeding attacks in cirrhotic patients.

Issued

1 Jan 2007

DOI

http://dx.doi.org/10.21473/iknito-space/32100

Details

Type

Thesis

Created At

31 Jan 2023