Role of non-invasive serological and CT imaging parameters in assessing portal hypertensive gastropathy severity

To compare serological and CT imaging parameters between the mild and severe portal hypertensive gastropathy (PHG) group, and find out the non-invasive predictive markers for PHG severity based on these differences.

Three hundred one patients were enrolled in our retrospective study. The PHG severity was assessed by esophagogastroduodenoscopy (EGD), and serological markers were measured within 48 h before EGD, and CT scans were performed within one week after EGD. Differences in age, gender, etiology, serological and CT imaging parameters, and arterial-phase gastric wall enhancement in CT scans were analyzed between the mild and severe PHG groups.

No significant differences were observed in gender, age, etiology, serological markers, or MELD score between the two groups (all P > 0.05). However, spleen length, spleen volume, PLT/spleen length ratio, and PLT/spleen volume ratio differed significantly (P = 0.003, 0.011, 0.019, and 0.014, respectively). The optimal cutoff values for predicting PHG severity were 131.4 (AUC = 0.619), 613.29 (AUC = 0.596), 0.42 (AUC = 0.588), and 0.07 (AUC = 0.592), respectively. Patients with severe PHG demonstrated significantly greater arterial-phase gastric wall enhancement compared to mild PHG cases.

Spleen length, spleen volume, and the platelet-to-spleen ratios presented predictive value for PHG severity, albeit with limited discriminative ability. Additionally, moderate-to-severe arterial phase gastric wall enhancement in CT scans may serve as a potential indicator of severe PHG.