Assessment of high-risk gastroesophageal varices in cirrhotic patients using quantitative parameters from dual-source dual-energy CT

To investigate the clinical value of dual-source dual-energy CT (dsDECT) quantitative parameters in evaluating hemodynamics and predicting high-risk gastroesophageal varices in cirrhotic patients.

98 consecutive patients were collected in this prospectively study and all patients underwent an abdominal triple-phase contrasted-enhanced examination with dsDECT. Iodine concentration (IC) and normalized iodine concentration (NIC) of the liver parenchyma, spleen parenchyma and aorta at different phases were recorded, and arterial iodine fraction (AIF), iodine washout rate (IWR), and extracellular volume (ECV) were calculated. Using upper gastrointestinal endoscopy as the reference standard, patients who met the inclusion and exclusion criteria were divided into groups with varices need treatment (VNT) and non-VNT. The clinical characteristics, traditional CT features and quantitative dsDECT parameters were compared between the VNT group and the non-VNT group using univariate analysis. The binary logistics analysis was used to build a model for diagnosing VNT. The receiver operating characteristic (ROC) curve was used for analysis and the DeLong test was used to compare different ROC curves.

Finally, 57 patients were included in this study. Univariate analysis showed statistically significant differences in NIC of the liver at the portal venous phase (NIC-L_PVP), IWR of the liver (IWR-L) and spleen volume between the VNT group and the non-VNT group (p < 0.05). The mixed-CT model was built by binary logistics analysis. The ROC curves of NIC-L_PVP, IWR-L, spleen volume and the mixed-CT model were statistically significant (p < 0.05) for predicting VNT in cirrhotic patients, among which the area under the ROC curve of the mixed-CT model was the highest.

Dual-source dual-energy CT has added clinical value in evaluating hepatic hemodynamics and diagnosing VNT in patients with liver cirrhosis.