Detection of esophageal varices using CT and XXXX .

@entity1 @entity101 @entity7994 @entity548 @entity2286
BACKGROUND AND AIMS: The development of esophageal varices in cirrhotic @entity1 carries a significant risk of @entity548 and associated morbidity/mortality. Universal endoscopic screening, however, is invasive and expensive. Conversely, cirrhotic @entity1 often have imaging findings which suggest portal @entity101 . The aim of this study was to evaluate the ability of CT and/or @entity7994 to detect esophageal varices compared to EGD. METHODS: Medical records from 2000 to 2007 were retrospectively reviewed. CT and/or @entity7994 images were included if performed within 90 days of EGD. Two blinded, experienced radiologists were asked to review images for the presence of esophageal varices, as well as other findings associated with portal @entity101 . Sensitivity, specificity, @entity2286 and NPV were calculated using EGD findings as the gold standard. RESULTS: A total of 195 @entity1 and 142 @entity1 met criteria for @entity7994 , respectively. The sensitivity of CT to detect EGD varices was 58-89%, but increased to 65-100% when specifically looking at large endoscopic varices. Overall specificity was 68-82%, but increased to 97-100% when applying >= 4 mm varices criteria. CT was superior to @entity7994 in the detection of endoscopic varices; the addition of other portal @entity101 stigmata did not improve results. CONCLUSIONS: The exclusion of large endoscopic varices by CT, using standardized criteria, may obviate the need or frequency of EGD screening in select @entity1 populations. Alternatively, CT findings highly suggestive of esophageal varices in cirrhotic @entity1 may warrant further investigation and/or treatment. Further studies are needed to validate these findings.
