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Asian J Surg. 2011 Oct;34(4):168-74. doi: 10.1016/j.asjsur.2011.11.006. Epub 2012 Feb 16.

Computed tomography indices and criteria for the prediction of esophageal variceal bleeding in survivors of biliary atresia awaiting liver transplantation.

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1
Department of Medical Imaging, National Taiwan University Hospital and Medical School, Taipei, Taiwan, ROC.

Abstract

BACKGROUND/OBJECTIVE:

About 20% of biliary atresia (BA) survivors have attacks of esophageal variceal bleeding. We propose a method to evaluate the risk of esophageal variceal bleeding (EVB) using noninvasive indices by multislice computed tomography (CT).

METHODS:

We reviewed 31 potential living-related liver recipients aged 99-5314 days (mean, 1474 days) who underwent CT examinations using a 64-slice multislice CT scanner. Of the 31 patients, 19 patients (Group A) with fecal occult blood had EVB on esophagogastroduodenoscopy; the rest belonged to Group B. Splenic diameters (mm) were divided by body heights (m) and platelet counts (1000/mm(3)) to produce standardized ratios of transverse splenic length/body height/platelet count (SLHPR). The transverse diameters of paraesophageal veins (PVs) and perigastric veins (PGVs) were measured adjacent to the lower thoracic esophagus and within the lesser sac, respectively.

RESULTS:

According to a receiver operating characteristic curve analysis, the SLHPRs (r=0.833), transverse PV (r=0.957), and PGV (r=0.987) diameters were better predictors of EVB than demographic and laboratory variables. However, the transverse diameters of PGVs and PVs were the most accurate predictors of the EVB.

CONCLUSION:

For candidates awaiting liver transplantation, screening by noninvasive SLHPR and the transverse diameters of PGVs and PVs by CT may help to identify BA patients with a high risk of EVB.

PMID:
22464833
DOI:
10.1016/j.asjsur.2011.11.006
[Indexed for MEDLINE]
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