The MDCT Sore And The Clinical Significance Of The Paraesophageal Varices Of Portal Hypertension

Objectives:To evaluate the relationship between the paraesophageal varices and the esophageal varices by multidetector-row computed tomography (MDCT), with endoscopy as the reference standard. To estimate the clinical significance of the paraesophageal varices.Materials and Methods:Retrospective analysis were performed in 99 patients who had been diagnosed with portal hypertension. After image postprocessing, the number and the maximum short axis of the varices were recorded to grade the paraesophageal varcies and the esophageal varices at MDCT; the diameters of the main portal vein, the splenic vein, the left gastric vein, the azygous vein and the splenic thickness were all measured. Esophageal varices were also graded both in forms and red color sign at endoscopy. And the data of albumin,serum bilirubin and platelet were recorded, too. The statistical analysis was performed by use of SPSS 17.0. The MDCT scores of the paraesophageal varicesand esophageal varices were analyzed by spearman's rank correlation analysis. The MDCT scores of the paraesophageal varices and the esophageal varices were also compared to the endoscopic grades of the esophageal varices by spearman's rank correlation analysis. The data concerning paraesophageal variceal MDCT scores differences in main portal vein diameter, splenic vein diameter, left gastric vein diameter, azygous vein diameter, splenic thickness and albumin, serum bilirubin, platelet were retrospectively analyzed by one-way ANOVA.Result:The MDCT score of the paraesophageal varices had significant correlation with the MDCT score of the esophageal varices (P=0.008, r=0.266), but had no significant correlation with the endoscopic grades of the esophageal varices(P=0.832). The MDCT score of the esophageal varices had significant correlation with the endoscopic grades of the esophageal varices (P=0.000, r=0.719). There was significant deviation among different MDCT scores that diameters ofthe left gastric vein (P=0.028). There was no significant deviation among different MDCT scores that diameters of azigous vein, splenic vein, main portal vein, splenic thickness, albumin, serum bilirubin or platelet (P=0.213,0.262,0.929,0.053,0.653,0.962,0.717, respectively).Conclusion:The MDCT score of the paraesophageal vrices had significant correlation with the MDCT score of the esophageal varices. There was no significant deviation among different MDCT scores that other indexes of portal hypertension, except the diameter of the left gastric vein.