Division of Medicine and Clinical Science, Department of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
BMC Med Imaging. 2021 Aug 9;21(1):120. doi: 10.1186/s12880-021-00655-8.
Gastroesophageal varices (GOV) are a life-threatening complication in chronic liver disease. A method for non-invasively predicting GOV is crucial for management. This study aimed to determine whether a vein-viewing application can detect abdominal wall varices (AWV) and elucidate the relationship between AWV and GOV.
One-hundred patients with chronic liver diseases were prospectively enrolled. All the patients underwent esophagogastroduodenoscopy within three months of the enrollment. Unmanipulated images (UI) and vein-weighted images (VWI) were taken for assessing AWV by a vein-viewing application on iPhone. Two doctors independently evaluated both image types. We defined the grading of both UI and AWV as grade 0 (non-detectable), grade 1 (slightly detectable), and grade 2 (distinct).
The causes of liver diseases among the 71 men and 29 women (median age, 70.5 yr) included Hepatitis B (n = 19), Hepatitis C (n = 21), alcoholism (n = 33), primary biliary cholangitis (n = 3), autoimmune hepatitis (n = 4) and others (n = 20). GOV was indicated in 60 patients, and half of them had not been treated previously (non-treated). VWI could significantly visualize AWV than UI (72% vs. 24%, p = 0.0005). The presence of cirrhosis (chronic hepatitis vs. cirrhosis = 64.6% vs. 91.4%, p = 0.004) and GOV (52.3% vs. 74.3%, p = 0.032) were significantly higher in the VWI-AWV grade 2 group. Multivariate analysis demonstrated that VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV [OR = 3.05 (1.24-7.53), p = 0.016].
The vein-viewing application non-invasively detected AWV related to the presence of cirrhosis and GOV, and VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV.
胃食管静脉曲张（GOV）是慢性肝病的一种危及生命的并发症。一种能够非侵入性预测 GOV 的方法对于管理至关重要。本研究旨在确定一种静脉观察应用程序是否可以检测腹壁静脉曲张（AWV），并阐明 AWV 与 GOV 之间的关系。
前瞻性纳入 100 例慢性肝病患者。所有患者均在入组后三个月内接受食管胃十二指肠镜检查。使用 iPhone 上的静脉观察应用程序对未经处理的图像（UI）和静脉加权图像（VWI）进行 AWV 评估。两名医生分别对两种图像类型进行评估。我们将 UI 和 AWV 的分级定义为 0 级（不可检测）、1 级（轻度可检测）和 2 级（明显可检测）。
71 名男性和 29 名女性（中位年龄 70.5 岁）的肝病病因包括乙型肝炎（n=19）、丙型肝炎（n=21）、酒精中毒（n=33）、原发性胆汁性胆管炎（n=3）、自身免疫性肝炎（n=4）和其他（n=20）。60 例患者存在 GOV，其中一半患者之前未接受治疗（未治疗）。VWI 比 UI 能更明显地显示 AWV（72%比 24%，p=0.0005）。VWI-AWV 2 级组中肝硬化（慢性肝炎与肝硬化的比例为 64.6%与 91.4%，p=0.004）和 GOV（52.3%与 74.3%，p=0.032）的存在明显更高。多因素分析表明，VWI-AWV 2 级是与未治疗 GOV 存在相关的独立因素[OR=3.05（1.24-7.53），p=0.016]。
静脉观察应用程序非侵入性地检测到与肝硬化和 GOV 相关的 AWV，VWI-AWV 2 级是与未治疗 GOV 存在相关的独立因素。
