The diameter of the originating vein determines esophageal and gastric fundic varices in portal hypertension secondary to posthepatitic cirrhosis

Abstract

OBJECTIVE:The aim of this study was to determine whether and how the diameter of the vein that gives rise to the inflowing vein of the esophageal and gastric fundic varices secondary to posthepatitic cirrhosis, as measured with multidetector-row computed tomography, could predict the varices and their patterns.METHODS:A total of 106 patients with posthepatitic cirrhosis underwent multidetector-row computed tomography. Patients with and without esophageal and gastric fundic varices were enrolled in Group 1 and Group 2, respectively. Group 1 was composed of Subgroup A, consisting of patients with varices, and Subgroup B consisted of patients with varices in combination with portal vein-inferior vena cava shunts. The diameters of the originating veins of veins entering the varices were reviewed and statistically analyzed.RESULTS:The originating veins were the portal vein in 8% (6/75) of patients, the splenic vein in 65.3% (49/75) of patients, and both the portal and splenic veins in 26.7% (20/75) of patients. The splenic vein diameter in Group 1 was larger than that in Group 2, whereas no differences in portal vein diameters were found between groups. In Group 1, the splenic vein diameter in Subgroup A was larger than that in Subgroup B. A cut-off splenic vein diameter of 8.5 mm achieved a sensitivity of 83.3% and specificity of 58.1% for predicting the varices. For discrimination of the varices in combination with and without portal vein-inferior vena cava shunts, a cut-off diameter of 9.5 mm achieved a sensitivity of 66.7% and specificity of 60.0%.CONCLUSION:The diameter of the splenic vein can be used to predict esophageal and gastric fundic varices and their patterns.

Large Silent Gastric Fundal Varices in Cirrhotic Patients: Role of Abdominal Multidetector Triphasic Computed Tomography.

“…Because of the significant difference in SV diameter between patients with and without esophageal and gastric fundal varices, the SV diameter measurements can be used as criteria to predict the presence of varices with a cutoff SV diameter of 10 mm for differentiating PHT with and without esophageal and gastric fundal varices based on the present data and using ROC analysis and this in agreement of study done by Zhou et al [37]. However in this study, SV diameter failed to be independent predictors for presence of such varices.…”

Identification of Different Liver Diseases by Using Imagery Techniques: A Review.

“…This method effectively segments the Liver tumour when applied to abdominal CT images which is difficult to segment the tumour accurately. [8]: In this paper, the patterns and producing veins of the inflowing vessels of gastric fundic and esophageal varices were shown as correctly on CT-MPR images, which forward demonstrates the advantages of MDCT porto-graphy for evaluating varices.…”

A non‐invasive magnetic resonance imaging‐based model predicts portal venous pressure

“…LV and SV were independently obtained as a summation by tracing the boundaries manually on each transverse image and avoiding the large vessels and fissures. The PVD and PVCSA were measured at the midpoint between the portal bifurcations and the venous confluences while the SVD was measured at the point 1 cm proximal to their confluence with portal veins . The LHVD, MHVD and RHVD were assessed at the section where they converged into the inferior vena caval .…”

“…The PVD and PVCSA were measured at the midpoint between the portal bifurcations and the venous confluences while the SVD was measured at the point 1 cm proximal to their confluence with portal veins. 25,26 The LHVD, MHVD and RHVD were assessed at the section where they converged into the inferior vena caval. 27 The ratio of LV to body mass index (BMI) (LV/BMI) and that of SV to BMI (SV/BMI) were calculated to correct for body size.…”