Spleen Extracellular Volume Fraction on Computed Tomography as a Noninvasive Predictor of High-Risk Esophageal Varices in Patients with Cirrhosis
| Author | Mohammad Mersad Mansouri Tehrani | en |
| Author | Nasser Bahari | en |
| Author | Kian Goudarzi | en |
| Author | Faeze Salahshour | en |
| Author | Babak Shekarchi | en |
| Author | Mohammad Masih Mansouri-Tehrani | en |
| Author | Majid Nouri | en |
| Orcid | Mohammad Mersad Mansouri Tehrani [0000-0002-2987-2254] | en |
| Orcid | Faeze Salahshour [0000-0002-0342-0006] | en |
| Orcid | Babak Shekarchi [0009-0004-2251-8385] | en |
| Issued Date | 2024-10-31 | en |
| Abstract | Background: Bleeding esophago-gastric junction varices (EGV) represent a life-threatening complication of chronic liver disease. Endoscopic screening remains the standard for variceal risk assessment but is not universally accessible or feasible. The extracellular volume (ECV) fraction derived from contrast-enhanced computed tomography (CT) has demonstrated utility in identifying patients at risk for high-grade EGV and may serve as a predictive imaging biomarker for the high-risk variceal group (HRG). Patients and Methods: This retrospective analysis included patients with cirrhosis who underwent abdominal CT and esophagogastroduodenoscopy between 2019 and 2024 at a tertiary referral center in Tehran. A total of 62 patients (mean age, 50.2 ± 11.5 years; 62.9% male) were evaluated to differentiate between high-risk and non-high-risk variceal group (NHRG). Results: Spleen ECV, CT-based detection of varices, and Child-Pugh score were significantly associated with HRG. A spleen ECV threshold of 38.5 (95% CI, 0.896 - 1.000) demonstrated strong predictive performance. Increased splenic ECV correlated with an elevated risk of HRG. Conclusion: Splenic ECV is a significant noninvasive marker for identifying high-risk esophageal varices in cirrhotic patients. This parameter can be integrated into routine imaging evaluation without additional cost, time, or procedural risk. | en |
| DOI | https://doi.org/10.5812/iranjradiol-160073 | en |
| Keyword | High-Risk Esophago-Gastric Junction Varices | en |
| Keyword | Cirrhosis | en |
| Keyword | Splenic Extracellular Volume Fraction | en |
| Keyword | Computed Tomography | en |
| Keyword | Noninvasive Predictor | en |
| Publisher | Brieflands | en |
| Title | Spleen Extracellular Volume Fraction on Computed Tomography as a Noninvasive Predictor of High-Risk Esophageal Varices in Patients with Cirrhosis | en |
| Type | Research Article | en |