Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis.

Abstract:

BACKGROUND AND AIM:To explore the CT signs which permit estimation of clinically severe portal hypertension (PH) [≥ 12 of hepatic vein pressure gradient (HVPG)]. METHODS:One-hundred and seven consecutive patients who underwent HVPG measurement in the PH group and 52 controls were included. The diameters of main portal vein (øMPV), superior mesenteric vein (øSMV), splenic vein (øSV), and left gastric vein, øMPV/øSV, øSMV/øSV, as well as estimated spleen volumes were evaluated on the CT scan. The grade of varix and ascites were also evaluated semi-quantitatively. We explored the statistically significant CT features related to severe PH and performed a logistic regression analysis for an estimation model for severe PH. RESULTS:øMPV/øSV and øSMV/øSV tended to gradually increase as the PH became severer, and the difference between severe and not severe groups was statistically significant (p = 0.015 and 0.038, respectively). According to the regression analysis, øSMV/øSV and the grade of esophageal varix and ascites were finally included as related variables for predicting severe PH. The odds ratio (OR) of øSMV/øSV was 4.596, and large esophageal varix (OR 4.135) and mild (OR 3.051) and large amount of ascites (OR 21.781) were statistically significantly related to severe PH. CONCLUSION:Changing diameters of portal system, the grades of esophageal varices and ascites on multi-detector row computed tomography might be indicative features for clinically severe PH.

journal_name

Dig Dis Sci

authors

Lee JY,Kim TY,Jeong WK,Kim Y,Kim J,Kim KW,Kim YH,Sohn JH

doi

10.1007/s10620-014-3149-8

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

2333-43

issue

9

eissn

0163-2116

issn

1573-2568

journal_volume

59

pub_type

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