| Esophageal varices in cirrhotic patients: evaluation with liver CT. | |
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MedLine Citation:
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PMID: 17179356 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to evaluate the performance of routine helical liver CT in the detection and grading of esophageal varices in cirrhotic patients. MATERIALS AND METHODS: A total of 67 consecutive cirrhotic patients who underwent both upper endoscopy and helical liver CT within a 4-week interval were evaluated. The CT protocol included unenhanced, arterial, and portal phases with a collimation of 7-7.5 mm. Two blinded abdominal imagers (6 and 7 years' experience) retrospectively interpreted all CT images to detect the presence of esophageal varices on a 5-point confidence scale and measure the largest varix identified. Receiver operating characteristic (ROC) curve analysis was performed, and the correlation between CT measurements and endoscopic grading, the reference standard, was assessed. RESULTS: The variceal detection rates for the observers was 92% (11/12) and 92% (11/12) for large (i.e., clinically significant) varices, 53% (16/30) and 60% (18/30) for small varices, and 64% (27/42) and 69% (29/42) for all varices. The area under the ROC curve for the detection of esophageal varices of any size was 0.77 (observer 1) and 0.80 (observer 2). CT variceal grading showed a strong correlation with endoscopic grading for both observers (p < or = 0.001). Using a variceal diameter threshold of 3 mm on CT, sensitivity, specificity, and accuracy for distinguishing large esophageal varices from small or no varices were 92% (11/12), 84% (46/55), and 85% (57/67), respectively, for both observers. CONCLUSION: Liver CT is useful for the detection and grading of esophageal varices. A diameter of 3 mm may be an appropriate screening threshold for large clinically significant varices. |
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Authors:
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Young Jun Kim; Steven S Raman; Nam C Yu; Katherine J To'o; Rome Jutabha; David S K Lu |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 188 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2006-12-20 Completed Date: 2007-01-09 Revised Date: 2008-02-15 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 139-44 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave., Los Angeles, CA 90095-1721, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Esophageal and Gastric Varices / complications, radiography* Female Humans Liver / radiography* Liver Cirrhosis / complications, radiography* Male Middle Aged Radiographic Image Interpretation, Computer-Assisted / methods* Reproducibility of Results Retrospective Studies Sensitivity and Specificity Tomography, X-Ray Computed / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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