Research progress in CT study of lower esophageal varices with liver cirrhosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WAN Shang , HUANG Zixing ,  SONG Bin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

SONG Bin, Email: songlab_radiology@163.com

Keywords：

computed tomography; esophageal varices; liver cirrhosis; esophageal variceal bleeding; review

DOI：

10.7507/1007-9424.201904094

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the research progress of CT related to esophageal varices of cirrhotic patients complicated with portal hypertension.Methods Relevant CT literatures of esophageal varices of cirrhotic patients complicated with portal hypertension were collected to make an review,then summarized the research status and progress of CT in the diagnosis and evaluation of lower esophageal varices.Result CT had a good correlation with endoscopic diagnosis of esophageal varices, and CT was of great value in evaluating the presence, degree, and risk of esophageal varicose veins, especially in predicting the risk of esophageal varicose veins, which could be used as an effective modality to assist endoscopic examination to a certain extent.Conclusions CT is an important examination method for esophageal varices, which has important value in diagnosis and evaluation. In the future, more further researches can be carried out to provide more strong and accurate support for the diagnosis and treatment of esophageal varices.

Citation： WAN Shang, HUANG Zixing, SONG Bin. Research progress in CT study of lower esophageal varices with liver cirrhosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(6): 742-747. doi: 10.7507/1007-9424.201904094 Copy

1.	Kim YJ, Raman SS, Yu NC, et al. Esophageal varices in cirrhotic patients: evaluation with liver CT. AJR Am J Roentgenol, 2007, 188(1): 139-144.
2.	Dessouky BA, Abdel Aal el SM. Multidetector CT oesophagography: an alternative screening method for endoscopic diagnosis of oesophageal varices and bleeding risk. Arab J Gastroenterol, 2013, 14(3): 99-108.
3.	中華醫學會肝病學分會, 中華醫學會消化病學分會, 中華醫學會消化內鏡學分會. 肝硬化門靜脈高壓食管胃靜脈曲張出血的防治指南. 中華內科雜志, 2016, 55(1): 57-72.
4.	中華醫學會消化內鏡學分會. 食管胃靜脈曲張內鏡下診斷和治療規范試行方案 (2003 年). 中華消化內鏡雜志, 2004, 21(3): 149-151.
5.	Kim H, Choi D, Gwak GY, et al. Evaluation of esophageal varices on liver computed tomography: receiver operating characteristic analyses of the performance of radiologists and endoscopists. J Gastroenterol Hepatol, 2009, 24(9): 1534-1540.
6.	Sarin SK, Wadhawan M, Agarwal SR, et al. Endoscopic variceal ligation plus propranolol versus endoscopic variceal ligation alone in primary prophylaxis of variceal bleeding. Am J Gastroenterol, 2005, 100(4): 797-804.
7.	何欣, 黃仲奎, 龍莉玲, 等. 比較多層螺旋 CT 門靜脈成像與內鏡檢查診斷肝硬化合并食管胃靜脈曲張的優劣. 中華放射學雜志, 2012, 46(12): 1092-1095.
8.	靳勇, 吳云林, 王蕾, 等. 多層螺旋 CT 門靜脈血管成像與內鏡對食管、胃靜脈曲張診斷的比較研究. 中華消化雜志, 2007, 27(2): 78-82.
9.	陳旭平, 蔣志凌, 陳霞, 等. CT 門靜脈血管成像與內鏡診斷胃食管靜脈曲張的比較. 華西醫學, 2013, 28(2): 240-243.
10.	劉桂勤, 華靜, 沈加林. CT 門靜脈血管成像預測肝硬化門靜脈高壓食管胃底靜脈曲張破裂出血價值. 中華實用診斷與治療雜志, 2015, 29(4): 396-398.
11.	Kim SH, Kim YJ, Lee JM, et al. Esophageal varices in patients with cirrhosis: multidetector CT esophagography–comparison with endoscopy. Radiology, 2007, 242(3): 759-768.
12.	翟紅軍. 螺旋 CT 門靜脈造影成像與胃鏡對肝硬化、食管胃底靜脈曲張對比的價值探討. 按摩與康復醫學: 下旬刊, 2012, 3(8): 15-16.
13.	蔣志凌, 陳旭平, 付冰, 等. 肝硬化食管靜脈曲張程度門脾靜脈內徑及 Child-Pugh 分級的關系. 華西醫學, 2011, 26(2): 187-188.
14.	de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno Ⅵ Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol, 2015, 63(3): 743-752.
15.	Garcia-Tsao G, Groszmann RJ, Fisher RL, et al. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology, 1985, 5(3): 419-424.
16.	Polio J, Groszmann RJ, Reuben A, et al. Portal hypertension ameliorates arterial hypertension in spontaneously hypertensive rats. J Hepatol, 1989, 8(3): 294-301.
17.	秦將均, 涂蓉, 巫北海, 等. 胃左靜脈的多層螺旋 CT 評價對預測食管靜脈曲張出血風險的價值. 實用放射學雜志, 2011, 27(9): 1366-1369.
18.	宋兵, 李彩英, 劉增品, 等. 胃左靜脈 MSCTA 預測肝硬化門靜脈高壓食管胃底靜脈曲張破裂岀血的價值. 臨床放射學雜志, 2011, 30(7): 979-983.
19.	梁曉春, 王維, 王小宜, 等. CT 預測肝硬化門靜脈高壓并發上消化道出血風險的 ROC 分析. 臨床放射學雜志, 2006, 25(5): 434-438.
20.	張鑫, 孫浩, 許金衛. 肝硬化門脈高壓患者食管靜脈曲張 CT 表現預測首次上消化道出血的風險. 中華臨床醫師雜志: 電子版, 2013, 7(16): 122-123.
21.	Mifune H, Akaki S, Ida K, et al. Evaluation of esophageal varices by multidetector-row CT: correlation with endoscopic ‘red color sign’. Acta Med Okayama, 2007, 61(5): 247-254.
22.	North Italian Endoscopic club for the study and treatment of esophageal varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med, 1988, 319(15): 983-989.
23.	Miller L, Banson FL, Bazir K, et al. Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross-sectional surface area. Am J Gastroenterol, 2003, 98(2): 454-459.
24.	Rice JP, Lubner M, Taylor A, et al. CT portography with gastric variceal volume measurements in the evaluation of endoscopic therapeutic efficacy of tissue adhesive injection into gastric varices: a pilot study. Dig Dis Sci, 2011, 56(8): 2466-2472.
25.	何欣, 黃仲奎, 龍莉玲, 等. 肝硬化并食管靜脈曲張多層螺旋 CT 門靜脈成像的臨床應用. 實用放射學雜志, 2012, 28(11): 1707-1711.
26.	Hino S, Kakutani H, Ikeda K, et al. Hemodynamic analysis of esophageal varices using color Doppler endoscopic ultrasonography to predict recurrence after endoscopic treatment. Endoscopy, 2001, 33(10): 869-872.
27.	譚友文, 於學軍, 殷玉梅. 肝硬化門靜脈高壓門脈血流動力學檢測及其臨床意義. 中華超聲影像學雜志, 2001, 10(3): 151-153.
28.	郝婷婷, 馬曉鵬, 戴光榮, 等. 肝硬化門靜脈高壓患者食管靜脈曲張 CT 表現預測首次上消化道出血的價值. 胃腸病學和肝病學雜志, 2017, 26(1): 29-31.
29.	余楊紅, 丁山, 鄧克學. 多層螺旋 CT 門靜脈成像對食管胃底靜脈曲張出血的評價. 安徽醫科大學學報, 2013, 48(11): 1376-1379.
30.	欒立, 段紅霞, 劉嚴明, 等. CT 測量脾臟指數預判肝硬化食管靜脈曲張及出血的可能. 實用放射學雜志, 2006, 22(4): 421-423.
31.	Calame P, Ronot M, Bouveresse S, et al. Predictive value of CT for first esophageal variceal bleeding in patients with cirrhosis: value of para-umbilical vein patency. Eur J Radiol, 2017, 87: 45-52.
32.	Yang CT, Chen HL, Ho MC, et al. Computed tomography indices and criteria for the prediction of esophageal variceal bleeding in survivors of biliary atresia awaiting liver transplantation. Asian J Surg, 2011, 34(4): 168-174.
33.	劉成環, 任明思, 李俊華, 等. 肝硬化門靜脈高壓患者臍靜脈開放的 CT 診斷價值. 青海醫藥雜志, 2010, 40(6): 57-59.
34.	褚倩, 李震, 張蘇明, 等. 肝性腦病與門靜脈高壓側枝循環形成的關系—CT 門靜脈造影的監測價值. 中國醫學影像學雜志, 2004, 12(1): 1-3.
35.	雷釗. 食管旁靜脈與食管靜脈曲張的相關性. 中國普通外科雜志, 2012, 21(12): 1571-1573.
36.	Kodama H, Aikata H, Takaki S, et al. Evaluation of portosystemic collaterals by MDCT-MPR imaging for management of hemorrhagic esophageal varices. Eur J Radiol, 2010, 76(2): 239-245.
37.	Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol, 2003, 38(3): 266-272.
38.	李偉. 多層螺旋 CT 門靜脈成像評估肝硬化食管靜脈曲張出血風險. 胃腸病學和肝病學雜志, 2013, 22(12): 1262-1266.
39.	Lin XZ, Miao F, Li JY, et al. High-definition CT Gemstone spectral imaging of the brain: initial results of selecting optimal monochromatic image for beam-hardening artifacts and image noise reduction. J Comput Assist Tomogr, 2011, 35(2): 294-297.
40.	Lv P, Lin XZ, Li J, et al. Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology, 2011, 259(3): 720-729.
41.	趙麗琴, 賀文, 李劍穎, 等. 應用能譜 CT 研究肝硬化門靜脈高壓患者肝血流動力學變化. 中華放射學雜志, 2011, 45(8): 782-783.
42.	王芳, 沈加林, 華靜, 等. 能譜 CT 評估肝硬化食管靜脈曲張程度的價值研究. 臨床放射學雜志, 2016, 35(2): 208-212.
43.	張軍, 鄧克學. 能譜 CT 預測肝硬化門靜脈高壓患者并發食管靜脈曲張破裂出血風險. 中國醫學影像技術, 2012, 28(12): 2201-2205.
44.	王道慶, 劉玉麗. 多層螺旋 CT 檢查輻射危害控制探討. 中國輻射衛生, 2016, 25(5): 569-572.
45.	李殊吏, 李青, 張翼, 等. 1 200 例腫瘤患者 CT 檢查輻射劑量的調查研究. 國際腫瘤學雜志, 2014, 41(4): 302-305.

1. Kim YJ, Raman SS, Yu NC, et al. Esophageal varices in cirrhotic patients: evaluation with liver CT. AJR Am J Roentgenol, 2007, 188(1): 139-144.
2. Dessouky BA, Abdel Aal el SM. Multidetector CT oesophagography: an alternative screening method for endoscopic diagnosis of oesophageal varices and bleeding risk. Arab J Gastroenterol, 2013, 14(3): 99-108.
3. 中華醫學會肝病學分會, 中華醫學會消化病學分會, 中華醫學會消化內鏡學分會. 肝硬化門靜脈高壓食管胃靜脈曲張出血的防治指南. 中華內科雜志, 2016, 55(1): 57-72.
4. 中華醫學會消化內鏡學分會. 食管胃靜脈曲張內鏡下診斷和治療規范試行方案 (2003 年). 中華消化內鏡雜志, 2004, 21(3): 149-151.
5. Kim H, Choi D, Gwak GY, et al. Evaluation of esophageal varices on liver computed tomography: receiver operating characteristic analyses of the performance of radiologists and endoscopists. J Gastroenterol Hepatol, 2009, 24(9): 1534-1540.
6. Sarin SK, Wadhawan M, Agarwal SR, et al. Endoscopic variceal ligation plus propranolol versus endoscopic variceal ligation alone in primary prophylaxis of variceal bleeding. Am J Gastroenterol, 2005, 100(4): 797-804.
7. 何欣, 黃仲奎, 龍莉玲, 等. 比較多層螺旋 CT 門靜脈成像與內鏡檢查診斷肝硬化合并食管胃靜脈曲張的優劣. 中華放射學雜志, 2012, 46(12): 1092-1095.
8. 靳勇, 吳云林, 王蕾, 等. 多層螺旋 CT 門靜脈血管成像與內鏡對食管、胃靜脈曲張診斷的比較研究. 中華消化雜志, 2007, 27(2): 78-82.
9. 陳旭平, 蔣志凌, 陳霞, 等. CT 門靜脈血管成像與內鏡診斷胃食管靜脈曲張的比較. 華西醫學, 2013, 28(2): 240-243.
10. 劉桂勤, 華靜, 沈加林. CT 門靜脈血管成像預測肝硬化門靜脈高壓食管胃底靜脈曲張破裂出血價值. 中華實用診斷與治療雜志, 2015, 29(4): 396-398.
11. Kim SH, Kim YJ, Lee JM, et al. Esophageal varices in patients with cirrhosis: multidetector CT esophagography–comparison with endoscopy. Radiology, 2007, 242(3): 759-768.
12. 翟紅軍. 螺旋 CT 門靜脈造影成像與胃鏡對肝硬化、食管胃底靜脈曲張對比的價值探討. 按摩與康復醫學: 下旬刊, 2012, 3(8): 15-16.
13. 蔣志凌, 陳旭平, 付冰, 等. 肝硬化食管靜脈曲張程度門脾靜脈內徑及 Child-Pugh 分級的關系. 華西醫學, 2011, 26(2): 187-188.
14. de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno Ⅵ Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol, 2015, 63(3): 743-752.
15. Garcia-Tsao G, Groszmann RJ, Fisher RL, et al. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology, 1985, 5(3): 419-424.
16. Polio J, Groszmann RJ, Reuben A, et al. Portal hypertension ameliorates arterial hypertension in spontaneously hypertensive rats. J Hepatol, 1989, 8(3): 294-301.
17. 秦將均, 涂蓉, 巫北海, 等. 胃左靜脈的多層螺旋 CT 評價對預測食管靜脈曲張出血風險的價值. 實用放射學雜志, 2011, 27(9): 1366-1369.
18. 宋兵, 李彩英, 劉增品, 等. 胃左靜脈 MSCTA 預測肝硬化門靜脈高壓食管胃底靜脈曲張破裂岀血的價值. 臨床放射學雜志, 2011, 30(7): 979-983.
19. 梁曉春, 王維, 王小宜, 等. CT 預測肝硬化門靜脈高壓并發上消化道出血風險的 ROC 分析. 臨床放射學雜志, 2006, 25(5): 434-438.
20. 張鑫, 孫浩, 許金衛. 肝硬化門脈高壓患者食管靜脈曲張 CT 表現預測首次上消化道出血的風險. 中華臨床醫師雜志: 電子版, 2013, 7(16): 122-123.
21. Mifune H, Akaki S, Ida K, et al. Evaluation of esophageal varices by multidetector-row CT: correlation with endoscopic ‘red color sign’. Acta Med Okayama, 2007, 61(5): 247-254.
22. North Italian Endoscopic club for the study and treatment of esophageal varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med, 1988, 319(15): 983-989.
23. Miller L, Banson FL, Bazir K, et al. Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross-sectional surface area. Am J Gastroenterol, 2003, 98(2): 454-459.
24. Rice JP, Lubner M, Taylor A, et al. CT portography with gastric variceal volume measurements in the evaluation of endoscopic therapeutic efficacy of tissue adhesive injection into gastric varices: a pilot study. Dig Dis Sci, 2011, 56(8): 2466-2472.
25. 何欣, 黃仲奎, 龍莉玲, 等. 肝硬化并食管靜脈曲張多層螺旋 CT 門靜脈成像的臨床應用. 實用放射學雜志, 2012, 28(11): 1707-1711.
26. Hino S, Kakutani H, Ikeda K, et al. Hemodynamic analysis of esophageal varices using color Doppler endoscopic ultrasonography to predict recurrence after endoscopic treatment. Endoscopy, 2001, 33(10): 869-872.
27. 譚友文, 於學軍, 殷玉梅. 肝硬化門靜脈高壓門脈血流動力學檢測及其臨床意義. 中華超聲影像學雜志, 2001, 10(3): 151-153.
28. 郝婷婷, 馬曉鵬, 戴光榮, 等. 肝硬化門靜脈高壓患者食管靜脈曲張 CT 表現預測首次上消化道出血的價值. 胃腸病學和肝病學雜志, 2017, 26(1): 29-31.
29. 余楊紅, 丁山, 鄧克學. 多層螺旋 CT 門靜脈成像對食管胃底靜脈曲張出血的評價. 安徽醫科大學學報, 2013, 48(11): 1376-1379.
30. 欒立, 段紅霞, 劉嚴明, 等. CT 測量脾臟指數預判肝硬化食管靜脈曲張及出血的可能. 實用放射學雜志, 2006, 22(4): 421-423.
31. Calame P, Ronot M, Bouveresse S, et al. Predictive value of CT for first esophageal variceal bleeding in patients with cirrhosis: value of para-umbilical vein patency. Eur J Radiol, 2017, 87: 45-52.
32. Yang CT, Chen HL, Ho MC, et al. Computed tomography indices and criteria for the prediction of esophageal variceal bleeding in survivors of biliary atresia awaiting liver transplantation. Asian J Surg, 2011, 34(4): 168-174.
33. 劉成環, 任明思, 李俊華, 等. 肝硬化門靜脈高壓患者臍靜脈開放的 CT 診斷價值. 青海醫藥雜志, 2010, 40(6): 57-59.
34. 褚倩, 李震, 張蘇明, 等. 肝性腦病與門靜脈高壓側枝循環形成的關系—CT 門靜脈造影的監測價值. 中國醫學影像學雜志, 2004, 12(1): 1-3.
35. 雷釗. 食管旁靜脈與食管靜脈曲張的相關性. 中國普通外科雜志, 2012, 21(12): 1571-1573.
36. Kodama H, Aikata H, Takaki S, et al. Evaluation of portosystemic collaterals by MDCT-MPR imaging for management of hemorrhagic esophageal varices. Eur J Radiol, 2010, 76(2): 239-245.
37. Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol, 2003, 38(3): 266-272.
38. 李偉. 多層螺旋 CT 門靜脈成像評估肝硬化食管靜脈曲張出血風險. 胃腸病學和肝病學雜志, 2013, 22(12): 1262-1266.
39. Lin XZ, Miao F, Li JY, et al. High-definition CT Gemstone spectral imaging of the brain: initial results of selecting optimal monochromatic image for beam-hardening artifacts and image noise reduction. J Comput Assist Tomogr, 2011, 35(2): 294-297.
40. Lv P, Lin XZ, Li J, et al. Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology, 2011, 259(3): 720-729.
41. 趙麗琴, 賀文, 李劍穎, 等. 應用能譜 CT 研究肝硬化門靜脈高壓患者肝血流動力學變化. 中華放射學雜志, 2011, 45(8): 782-783.
42. 王芳, 沈加林, 華靜, 等. 能譜 CT 評估肝硬化食管靜脈曲張程度的價值研究. 臨床放射學雜志, 2016, 35(2): 208-212.
43. 張軍, 鄧克學. 能譜 CT 預測肝硬化門靜脈高壓患者并發食管靜脈曲張破裂出血風險. 中國醫學影像技術, 2012, 28(12): 2201-2205.
44. 王道慶, 劉玉麗. 多層螺旋 CT 檢查輻射危害控制探討. 中國輻射衛生, 2016, 25(5): 569-572.
45. 李殊吏, 李青, 張翼, 等. 1 200 例腫瘤患者 CT 檢查輻射劑量的調查研究. 國際腫瘤學雜志, 2014, 41(4): 302-305.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress in CT study of lower esophageal varices with liver cirrhosis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content