Mansouri Tehrani Mohammad Mersad, Bahari Nasser, Goudarzi Kian, Salahshour Faeze, Shekarchi Babak, Mansouri-Tehrani Mohammad Masih, Nouri Majid
Radiation Sciences Research Center Aja University of Medical Sciences Tehran Iran.
Cancer Research Center Shahid Beheshti University of Medical Science Tehran Iran.
Health Sci Rep. 2025 May 22;8(5):e70840. doi: 10.1002/hsr2.70840. eCollection 2025 May.
Liver cirrhosis is a severe condition that can result in complications such as portal hypertension and esophageal varices (EVs). While current guidelines recommend screening for EVs, existing procedures are often invasive, costly, and occasionally unreliable. This study aims to develop a CT-based predictor for identifying high-risk esophageal varices group (HRG) in cirrhotic patients, offering a noninvasive, safe, and cost-effective alternative that integrates seamlessly into routine follow-up without requiring additional resources or time.
The study retrospectively analyzed data from 2016 to 2021 of cirrhotic patients referred to a hospital in Tehran. Experienced professionals analyzed factors related to CT scans, and patients were categorized into high-risk and non-high-risk varicose veins groups by endoscopy. The main sample size for the study was 62 patients with an average age of 50.2 ± 11.5 years. Also, we aimed to determine a diagnostic cutoff and externally validated it in a separate statistical population (29 patients).
The study found that liver attenuation subtraction, Child-Pugh score, and direct visualization of esophageal varices in CT scans were significant factors in predicting high-risk esophageal varices. The study showed that a liver attenuation subtraction of 14.5 HU (CI 95%: 0.949-1) with an inverse relationship could predict high-risk esophageal varices with high accuracy.
The study indicated that liver "Attenuation Subtraction" in CT scans distinguishes high-risk and non-high-risk esophageal varices. Furthermore, external validation demonstrated that this cutoff value is generalizable to other statistical populations. We pinpoint an indicator of high-risk esophageal varices in patients with cirrhosis devoid of invasiveness and peril and do not impose supplementary expenses or time beyond the customary monitoring of cirrhotic patients.
肝硬化是一种严重疾病，可导致门静脉高压和食管静脉曲张（EVs）等并发症。虽然当前指南建议对食管静脉曲张进行筛查，但现有检查方法往往具有侵入性、成本高且偶尔不可靠。本研究旨在开发一种基于CT的预测指标，用于识别肝硬化患者中的高风险食管静脉曲张组（HRG），提供一种无创、安全且具有成本效益的替代方法，可无缝整合到常规随访中，无需额外资源或时间。
本研究回顾性分析了2016年至2021年转诊至德黑兰一家医院的肝硬化患者的数据。经验丰富的专业人员分析了与CT扫描相关的因素，并通过内镜检查将患者分为高风险和非高风险静脉曲张组。该研究的主要样本量为62例患者，平均年龄为50.2±11.5岁。此外，我们旨在确定一个诊断界值，并在一个单独的统计人群（29例患者）中对其进行外部验证。
研究发现，肝脏衰减差值、Child-Pugh评分以及CT扫描中食管静脉曲张的直接可视化是预测高风险食管静脉曲张的重要因素。研究表明，肝脏衰减差值为14.5 HU（95%置信区间：0.949 - 1）且呈负相关时，能够高精度地预测高风险食管静脉曲张。
该研究表明，CT扫描中的肝脏“衰减差值”可区分高风险和非高风险食管静脉曲张。此外，外部验证表明该界值可推广至其他统计人群。我们确定了一种肝硬化患者高风险食管静脉曲张的指标，其无侵入性和危险性，且不会在肝硬化患者的常规监测之外增加额外费用或时间。
