Multi-slice spiral computed tomography portography is valuable to predict esophageal variceal bleeding and hepatic encephalopathy in patients with cirrhosis

Aims: The present study is to use 64-slice MSCTP to investigate how main portal vein diameter, intrahepatic vein imaging, collateral opening, and the formation of portal vein embolus and hepatic artery-portal vein fistula are related with Child-Pugh staging, esophageal variceal bleeding and hepatic encephalopathy in patients with hepatic cirrhosis. Methods: A total of 64 patients with hepatic cirrhosis who were hospitalized between May 2012 and October 2014 were included in the present study. All patients were scanned using SOMATOM Sensation 64-slice spiral CT scanner. In Maxview workstation, the images were subjected to maximum intensity projection, volume reconstruction and multiplanar three-dimensional reconstruction. The diameters of main portal vein (MPV), intrahepatic left (IHLPV) and right (IHRPV) portal vein, splenic vein (SPV), and left gastric vein (LGV) were measured. In addition, opening of collateral circulation, existence of portal vein embolus, or formation of hepatic artery-portal vein fistula were examined. Double-blind method was used to analyze the lesions of portal vein system. Results: Cirrhosis expanded the diameters of blood vessels in portal vein system. Patients with Child-Pugh grade C had larger diameters of blood vessels in portal vein system compared with those with grade A. Digestive tract bleeding increased the diameters of MPV, SPV, LGV and IHLPV in portal vein system. The diameter of LGV was used for the prediction of EVB. Patients with HE stage III had larger diameters of LGV, SPV, IHLPV and IHRPV than patients with HE stage I. HE staging was correlated with the formation of portal vein embolus and hepatic artery-portal vein fistula in portal vein system. MSCTP grading had consistent grading of cirrhosis lesion severity with Child-Pugh grading. Conclusions: The present study demonstrates that MSCTP is capable of predicting risks for esophageal variceal bleeding and hepatic encephalopathy.