Role of MDCT in Grading of Esophageal Varices

The Role of Multidetector Computed Tomography(MDCT) in Grading of Oesophageal Varices in Cirrhotic Patients in Comparison to Endoscopy

Esophageal varices are one of the major complications of liver cirrhosis.Accurate grading of these varices is essential for effective management . Traditionally, esophagogastroduodenoscopy is the gold standard for diagnosing and grading esophageal varices,Multi detector computed tomography (MDCT) has emerged as a non-invasive alternative for evaluating esophageal varices.it particularly appealing for patients who contraindicated to endoscopy .

Esophageal varices are one of the major complications of liver cirrhosis, with an estimated prevalence of approximately 80% with decompensated patients and 50% in compensated cirrhosis, pose a significant risk of life-threatening of bleeding due to portal hypertension. Accurate grading of these varices is essential for effective management . Traditionally, esophagogastroduodenoscopy (EGD) is the gold standard for diagnosing and grading esophageal varices . IT provides direct visualization, allowing for detailed assessment of variceal size and other risk factors for bleeding . However, it is an invasive procedure that requires sedation and carries some risks, such as bleeding or perforation .

Multi detector computed tomography (MDCT) has emerged as a non-invasive alternative for evaluating esophageal varices. It offers detailed cross-sectional images and is widely available, providing a broader assessment of abdominal pathology. Its non-invasive nature makes it particularly appealing for patients who contraindicated to endoscopy .

Inclusion Criteria:

-Cirrhotic patients with portal hypertension undergoing upper GI endoscopy.

Exclusion Criteria:

-Contraindication to contrast:( severe renal insufficiency, allergy to contrast agents).

-Previous history of upper GI endoscopy with intervention (band ligation or sclerotherapy).-

• Pregnancy.
• Patients with previous transjagular intrahepatic portosystemic shunt (TIPS).
• Patients with contraindication to endoscopy (severe cardiopulmonary conditions, coma "unless the patient is intubated", and cardiac arrhythmias)