Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China.
Postgraduate College, Dalian Medical University, Dalian, China.
J Evid Based Med. 2017 Feb;10(1):46-52. doi: 10.1111/jebm.12226.
Esophageal variceal bleeding is a life-threatening complication of liver cirrhosis. Upper gastrointestinal endoscopy was the gold standard for the diagnosis of esophageal varices (EVs). The study aimed to evaluate the accuracy of contrast-enhanced computed tomography (CT) in the diagnosis of EVs and moderate-severe EVs in patients with liver cirrhosis.
Medical records in cirrhotic patients who were admitted to our hospital between June 2012 and June 2014 were retrospectively reviewed. Two observers reviewed the contrast-enhanced CT scans to evaluate the presence and diameter of EVs. Area under curve (AUC), sensitivity, and specificity were calculated.
A total of 52 cirrhotic patients were included in our study. According to the endoscopic results, 13.5% of these patients did not have any EVs, 11.5% had mild EVs, and 75% had moderate-severe EVs. The AUC of contrast-enhanced CT scans for the diagnosis of EVs was 0.835. The sensitivity and specificity were 95.56% and 71.43%, respectively. The AUC of contrast-enhanced T scans for the diagnosis of moderate-severe EVs was 0.821. When the cut-off value for the diameter of EVs on contrast-enhanced CT scans was 3.9 mm, the sensitivity and specificity were 89.74% and 69.23%, respectively.
Contrast-enhanced CT scans had a moderate diagnostic accuracy for EVs in liver cirrhosis. It might be useful to decrease the use of upper gastrointestinal endoscopy in clinical practice.
食管胃静脉曲张出血是肝硬化的一种危及生命的并发症。上消化道内镜检查是诊断食管静脉曲张（EVs）的金标准。本研究旨在评估对比增强 CT（CECT）在诊断肝硬化患者 EVs 和中重度 EVs 的准确性。
回顾性分析 2012 年 6 月至 2014 年 6 月期间我院收治的肝硬化患者的病历。两名观察者对增强 CT 扫描评估 EVs 的存在和直径。计算曲线下面积（AUC）、敏感性和特异性。
本研究共纳入 52 例肝硬化患者。根据内镜结果，13.5%的患者没有任何 EVs，11.5%的患者有轻度 EVs，75%的患者有中重度 EVs。CECT 扫描诊断 EVs 的 AUC 为 0.835。敏感性和特异性分别为 95.56%和 71.43%。CECT 扫描诊断中重度 EVs 的 AUC 为 0.821。当 CECT 扫描上 EVs 直径的截断值为 3.9mm 时，敏感性和特异性分别为 89.74%和 69.23%。
CECT 扫描对肝硬化 EVs 的诊断具有中等准确性。它可能有助于减少临床实践中上消化道内镜的使用。
