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-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.

• Publication year

  2016

• Venue

  Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

• Publication date

  2016-07-01

• Fields of study

  Medicine

• Identifiers
  PMID 26751694PMCID 4700850
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Detection and grading of esophageal varices on liver CT: comparison of standard and thin-section multiplanar reconstructions in diagnostic accuracy.

  2011cited by this paper
• Detection of Esophageal Varices Using CT and MRI

  2011cited by this paper
• Utilization of Platelet Count Spleen Diameter Ratio in Predicting the Presence of Esophageal Varices in Patients With Cirrhosis

  2010influential reference
• A Liver Stiffness Measurement-Based, Noninvasive Prediction Model for High-Risk Esophageal Varices in B-Viral Liver Cirrhosis

  2010cited by this paper
• Noninvasive Prediction of Large Esophageal Varices in Chronic Liver Disease Patients

  2010influential reference
• Insulin resistance is a risk factor for esophageal varices in hepatitis C virus cirrhosis

  2009cited by this paper
• Predictors of esophageal varices in patients with HBV-related cirrhosis: a retrospective study

  2009cited by this paper
• External Validation of the Platelet Count/Spleen Diameter Ratio for the Diagnosis of Esophageal Varices in Hepatitis C Virus-Related Cirrhosis

  2009cited by this paper
• High-Risk Esophageal Varices in Patients Treated with Locoregional Therapies for Hepatocellular Carcinoma: Evaluation with Regular Follow-Up Liver CT

  2009cited by this paper
• PillCam ESO Versus Esophagogastroduodenoscopy in Esophageal Variceal Screening: A Decision Analysis

  2009cited by this paper
• Esophageal Capsule Endoscopy vs. EGD for the Evaluation of Portal Hypertension: A French Prospective Multicenter Comparative Study

  2009cited by this paper
• Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices.

  2009cited by this paper
• Gastric Varices in Patients With Portal Hypertension: Evaluation With Multidetector Row CT

  2009cited by this paper
• Platelet count/spleen diameter ratio for non-invasive prediction of high risk esophageal varices in cirrhotic patients.

  2009influential reference
• Evaluation of esophageal varices on liver computed tomography: Receiver operating characteristic analyses of the performance of radiologists and endoscopists

  2009cited by this paper
• A study comparing tolerability, satisfaction and acceptance of three different techniques for esophageal endoscopy: sedated conventional, unsedated peroral ultra thin, and esophageal capsule.

  2009cited by this paper
• Platelet count to spleen diameter ratio for the diagnosis of esophageal varices: Is it feasible?

  2008cited by this paper
• Comparison of esophageal capsule endoscopy and esophagogastroduodenoscopy for diagnosis of esophageal varices.

  2008cited by this paper
• Sedation and anesthesia in GI endoscopy.

  2008cited by this paper
• A prospective evaluation of computerized tomographic (CT) scanning as a screening modality for esophageal varices

  2008influential reference
• Study comparing oesophageal capsule endoscopy versus EGD in the detection of varices.

  2008cited by this paper
• Predicting failure to control bleeding and mortality in acute variceal bleeding.

  2008cited by this paper
• Sedation and anesthesia in GI endoscopy.

  2008cited by this paper
• The budget impact of endoscopic screening for esophageal varices in cirrhosis.

  2007cited by this paper
• Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): A Randomized Comparison of 3 Preventive Strategies

  2007cited by this paper
• Liver stiffness measurement predicts severe portal hypertension in patients with HCV‐related cirrhosis

  2007cited by this paper
• Non-invasive diagnosis of cirrhosis and the natural history of its complications.

  2007cited by this paper
• Esophageal varices in cirrhotic patients: evaluation with liver CT.

  2007cited by this paper
• Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis

  2007cited by this paper
• Esophageal varices in patients with cirrhosis: multidetector CT esophagography--comparison with endoscopy.

  2007influential reference
• Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies.

  2006cited by this paper
• Esophageal Capsule Endoscopy versus Esophagogastroduodenoscopy for Evaluating Portal Hypertension: a Prospective Comparative Study of Performance and Tolerance

  2006cited by this paper
• Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varices.

  2006cited by this paper
• Platelet Count/Spleen Diameter Ratio for the Noninvasive Diagnosis of Esophageal Varices: Results of a Multicenter, Prospective, Validation Study

  2006influential reference
• The accuracy of PillCam ESO capsule endoscopy versus conventional upper endoscopy for the diagnosis of esophageal varices: a prospective three-center pilot study.

  2006cited by this paper
• Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension.

  2005cited by this paper
• Feasibility and Safety of String Wireless Capsule Endoscopy in the Diagnosis of Esophageal Varices

  2005cited by this paper
• Measurement of observer agreement.

  2003cited by this paper
• Incidence and natural history of small esophageal varices in cirrhotic patients.

  2003cited by this paper
• Endoscopic screening for esophageal varices in cirrhosis: Is it ever cost effective?

  2003cited by this paper
• Upper digestive bleeding in cirrhosis. Post‐therapeutic outcome and prognostic indicators

  2003cited by this paper
• Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosis

  2003cited by this paper
• ENDOSCOPIC SCREENING FOR ESOPHAGEAL VARICES IN CIRRHOSIS

  2001cited by this paper
• Prognostic indicators of risk for first variceal bleeding in cirrhosis: a multicenter study in 711 patients to validate and improve the North Italian Endoscopic Club (NIEC) index

  2000cited by this paper
• Updating consensus in portal hypertension: report of the Baveno III Consensus Workshop on definitions, methodology and therapeutic strategies in portal hypertension.

  2000cited by this paper
• Updating Consensus in Portal Hypertension: Report of the Baveno III Consensus Workshop on definitions, methodology and therapeutic strategies in portal hypertension

  2000cited by this paper
• Pharmacological Treatment of Portal Hypertension: An Evidence-Based Approach

  1999cited by this paper
• Comparing the sensitivities and specificities of two diagnostic procedures performed on the same group of patients.

  1997cited by this paper
• Comparing the sensitivities and specificities of two diagnostic procedures performed on the same group of patients

  1997influential reference
• Definitions, methodology and therapeutic strategies in portal hypertension. A Consensus Development Workshop, Baveno, Lake Maggiore, Italy, April 5 and 6, 1990.

  1992cited by this paper
• A prospective study of the ability of three endoscopic classifications to predict hemorrhage from esophageal varices.

  1992cited by this paper
• Agreement among multiple observers on endoscopic diagnosis of esophageal varices before bleeding

  1990cited by this paper
• Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study.

  1988cited by this paper
• The meaning and use of the area under a receiver operating characteristic (ROC) curve.

  1982cited by this paper

• The impact of hepatic and splenic volumetric assessment in imaging for chronic liver disease: a narrative review

  2024cites this paper
• Computed tomography for the diagnosis of gastroesophageal varices and risk assessment in patients with cirrhosis: a systematic review and meta-analysis

  2024cites this paper
• Platelet count/splenic diameter ratio: Analysis of its capacity as a predictor of the existence of esophageal varices in liver cirrhosis

  2023cites this paper
• Small varices in chronic liver diseases

  2022cites this paper
• Diagnostic accuracy of triphasic CT scan abdomen in the diagnosis of distal esophageal varices taking endoscopic findings as gold standard.

  2022cites this paper
• Mac-2 Binding Protein Glycosylation Isomer for Screening High-Risk Esophageal Varices in Liver Cirrhotic Patient

  2021cites this paper
• Accuracy of Multi-Detector Computed Tomography in Detection of Esophageal Varices in Chronic Liver Disease

  2020cites this paper
• Noninvasive evaluation of esophageal varices in cirrhotic patients based on spleen hemodynamics: a dual-energy CT study

  2020cites this paper
• Νon-invasive screening for esophageal varices in patients with liver cirrhosis

  2018influential citation
• Platelet Count to Spleen Diameter Ratio for the Diagnosis of Gastroesophageal Varices in Liver Cirrhosis: A Systematic Review and Meta-Analysis

  2017cites this paper
• Platelet count, spleen length, and platelet count-to-spleen length ratio for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis.

  2017cites this paper
• Evolving strategies for liver fibrosis staging: Non-invasive assessment

  2017cites this paper