Assessing the Accuracy of Contrast-Enhanced CT Abdomen in Identifying and Stratifying Risk of Oesophageal Varices in Cirrhotic Patients: A Retrospective Study

Oesophagogastroduodenoscopy (OGD) is the current standard for diagnosing and grading oesophageal varices (OV), but it is invasive and costly. This study retrospectively evaluated how well contrast-enhanced computed tomography (CT) scans of the abdomen perform in detecting and assessing the risk level of OV compared to OGD.

The study analyzed 92 cases of patients with liver cirrhosis who underwent contrast-enhanced CT within three months of having an OGD. Two experienced radiologists measured the largest OV diameter on CT images, which was then compared to OV grading from the OGD. Patient demographics, underlying causes of cirrhosis, and liver function classification were also reviewed.

Detection rates of varices by the two radiologists were moderate, with a combined sensitivity under 70%. For mild varices, CT showed moderate sensitivity and specificity but low detection rates. For moderate and severe varices, CT sensitivity and specificity varied, with overall accuracy just over 50%. There was no clear correlation between varix size on CT and variceal grade on OGD.

Contrast-enhanced CT has limited accuracy in detecting and grading OV compared to OGD, highlighting that OGD remains the preferred method for OV evaluation in patients with cirrhosis.