Therapeutic endoscopy of localized gastric varices: pretherapy screening and posttreatment evaluation with MDCT portography.

摘要

BACKGROUND: Gastric varices are a major cause of gastrointestinal bleeding in patients with portal hypertension. Whatever therapeutic method is used, hemodynamic changes in the portal systemic shunt should be assessed. In this study, we used multi-detector row CT portography as a screening and assessment tool. METHODS: A total of 85 patients with gastroscopy-confirmed gastroesophageal varices underwent multi-detector row CT portography. Patients through multi-detector row CT portography screening were recommended to therapeutic endoscopy. Multi-detector row CT portography was carried out in these patients one week before treatment and one month after treatment. The cross-sectional areas of the left gastric vein, main portal vein, superior mesenteric vein and splenic vein were measured by advanced vessel analysis software before and after treatment. Data was subjected to statistical test. RESULTS: Of the 85 patients who underwent multi-detector row CT portography screening, 17 had localized gastric varices with a solitary afferent vein and were recommended for therapeutic endoscopy. The changes in cross-sectional areas of the left gastric vein, main portal vein, superior mesenteric vein, and splenic vein before and after the treatment were of significant statistical difference. CONCLUSIONS: Multi-detector row CT portography is an effective screening and evaluating tool for therapeutic endoscopy.