Esophageal varices before and after endoscopic variceal ligation: evaluation using helical CT.
The purpose of this study was to demonstrate the utility of helical CT in assessing the therapeutic effects of endoscopic variceal ligation (EVL). Twenty-four patients with esophageal varices were examined. Helical scanning was initiated 60 s after intravenous injection (Iopamidol 300 mgI/ml, total 120 ml, 3 ml/s) was started. Esophageal varices were clearly depicted as high-density areas. Multiplanar reformation and 3D images demonstrated collateral circulation three-dimensionally. After EVL, mucosal high-density areas had diminished markedly, but collateral veins around the esophagus, and gastro- and/or spleno-renal shunts, were unchanged in all patients. Of 21 patients with collateral circulation, esophageal varices recurred endoscopically in 6 patients within 12 months. In 3 patients without collateral circulation, esophageal varices did not recur within 12 months. From these findings, we conclude that helical CT is a useful method for assessing the therapeutic effects of EVL.
Shimizu
T
T
Department of Radiology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka 569-0801, Japan.
Namba
R
R
Matsuoka
T
T
Tabuchi
K
K
Yamamoto
K
K
Uesugi
Y
Y
Matsui
R
R
Sueyoshi
K
K
Narabayashi
I
I
D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D016558:Hemostasis, Endoscopic; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data