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Varices in portal hypertension: evaluation with CT
K C Cho1, Y D Patel, R H Wachsberg
1Department of Radiology, University Hospital, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA.
Summary
Portal hypertension can cause numerous portosystemic varices. Dynamic computed tomography (CT) effectively visualizes these collateral vessels, aiding diagnosis.
Area of Science:
- Radiology
- Gastroenterology
- Vascular Imaging
Background:
- Portal hypertension leads to the development of portosystemic collateral channels.
- The appearance and prevalence of these varices vary significantly.
- Diagnostic modality impacts the reported prevalence of varices.
Purpose of the Study:
- To describe the CT appearance of portosystemic varices.
- To determine the prevalence of varices at different anatomic sites in patients with cirrhosis.
- To enhance diagnostic accuracy for portal hypertension complications.
Main Methods:
- Dynamic computed tomography (CT) with contrast material bolus was used.
- Sixty consecutive patients with varices and evidence of cirrhosis were evaluated.
- CT scans were analyzed for the presence and location of varices.
Main Results:
- Varices appeared as well-defined, tubular, or serpentine structures with homogeneous enhancement on CT.
- Coronary venous collateral vessels in the lesser omentum were the most common (80%).
- Other identified varices included esophageal, paraumbilical, and abdominal wall, among others, along with spontaneous shunts.
Conclusions:
- Dynamic CT provides detailed visualization of portosystemic collateral vessels.
- Understanding the CT characteristics and anatomic prevalence of varices improves diagnostic accuracy in portal hypertension.
- This knowledge is crucial for managing patients with cirrhosis and varices.