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Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices

BACKGROUND: All patients with liver cirrhosis should undergo screening endoscopy, but there are limitations and this approach places a heavy burden upon endoscopy units. The aim of this study was to compare multidetector computed tomography (MDCT) and the platelet/spleen diameter ratio as non-invasi...

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Autores principales: Karatzas, Andreas, Triantos, Christos, Kalafateli, Maria, Marzigie, Misiel, Labropoulou-Karatza, Chryssoula, Thomopoulos, Konstantinos, Petsas, Theodoros, Kalogeropoulou, Christina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700850/
https://www.ncbi.nlm.nih.gov/pubmed/26751694
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author Karatzas, Andreas
Triantos, Christos
Kalafateli, Maria
Marzigie, Misiel
Labropoulou-Karatza, Chryssoula
Thomopoulos, Konstantinos
Petsas, Theodoros
Kalogeropoulou, Christina
author_facet Karatzas, Andreas
Triantos, Christos
Kalafateli, Maria
Marzigie, Misiel
Labropoulou-Karatza, Chryssoula
Thomopoulos, Konstantinos
Petsas, Theodoros
Kalogeropoulou, Christina
author_sort Karatzas, Andreas
collection PubMed
description BACKGROUND: All patients with liver cirrhosis should undergo screening endoscopy, but there are limitations and this approach places a heavy burden upon endoscopy units. The aim of this study was to compare multidetector computed tomography (MDCT) and the platelet/spleen diameter ratio as non-invasive methods for the detection of gastroesophageal varices. METHODS: The study included 38 cirrhotics who underwent upper gastrointestinal (GI) endoscopy and MDCT within one month. Two radiologists reviewed the scans, in order to determine the presence and the size of varices. Blood tests and measurement of the spleen maximum diameter were also carried out and the platelet/spleen diameter ratio was calculated. Endoscopy was considered the gold standard and the results of the two methods were compared to it. RESULTS: Varices were detected by upper GI endoscopy in 24 of 38 patients. The mean sensitivity and specificity of MDCT for the two observers was 86.1% and 57.1% respectively. In patients with large varices (>5 mm), the sensitivity was 100% (4/4). Using 909 as a cut-off value of the platelet/spleen diameter ratio this method yielded a sensitivity of 56.5% and a specificity of 35.7%. The difference in sensitivity and specificity between the two methods was statistically significant P<0.05. CONCLUSION: MDCT was accurate for the detection of gastroesophageal varices, especially those with clinically significant size (>5 mm), and superior to platelet/spleen diameter ratio. MDCT could replace, in selected patients, upper GI endoscopy as a method for detecting gastroesophageal varices in cirrhotic patients.
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spelling pubmed-47008502016-01-08 Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices Karatzas, Andreas Triantos, Christos Kalafateli, Maria Marzigie, Misiel Labropoulou-Karatza, Chryssoula Thomopoulos, Konstantinos Petsas, Theodoros Kalogeropoulou, Christina Ann Gastroenterol Original Article BACKGROUND: All patients with liver cirrhosis should undergo screening endoscopy, but there are limitations and this approach places a heavy burden upon endoscopy units. The aim of this study was to compare multidetector computed tomography (MDCT) and the platelet/spleen diameter ratio as non-invasive methods for the detection of gastroesophageal varices. METHODS: The study included 38 cirrhotics who underwent upper gastrointestinal (GI) endoscopy and MDCT within one month. Two radiologists reviewed the scans, in order to determine the presence and the size of varices. Blood tests and measurement of the spleen maximum diameter were also carried out and the platelet/spleen diameter ratio was calculated. Endoscopy was considered the gold standard and the results of the two methods were compared to it. RESULTS: Varices were detected by upper GI endoscopy in 24 of 38 patients. The mean sensitivity and specificity of MDCT for the two observers was 86.1% and 57.1% respectively. In patients with large varices (>5 mm), the sensitivity was 100% (4/4). Using 909 as a cut-off value of the platelet/spleen diameter ratio this method yielded a sensitivity of 56.5% and a specificity of 35.7%. The difference in sensitivity and specificity between the two methods was statistically significant P<0.05. CONCLUSION: MDCT was accurate for the detection of gastroesophageal varices, especially those with clinically significant size (>5 mm), and superior to platelet/spleen diameter ratio. MDCT could replace, in selected patients, upper GI endoscopy as a method for detecting gastroesophageal varices in cirrhotic patients. Hellenic Society of Gastroenterology 2016 /pmc/articles/PMC4700850/ /pubmed/26751694 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Karatzas, Andreas
Triantos, Christos
Kalafateli, Maria
Marzigie, Misiel
Labropoulou-Karatza, Chryssoula
Thomopoulos, Konstantinos
Petsas, Theodoros
Kalogeropoulou, Christina
Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title_full Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title_fullStr Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title_full_unstemmed Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title_short Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
title_sort multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700850/
https://www.ncbi.nlm.nih.gov/pubmed/26751694
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