Per rectal portal scintigraphy as a useful tool for predicting esophageal variceal bleeding in cirrhotic patients.
OBJECTIVE
To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.


METHODS
Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using (99m)Technetium pertechnetate. The shunt index was calculated from the ratio of (99m)Technetium pertechnetate in the heart and the liver. Data were analyzed using Student's t-test and receiver operating characteristics.


RESULTS
Cirrhotic patients showed a higher shunt index than normal subjects (63.80 +/- 25.21 vs 13.54 +/- 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 +/- 9.40 vs 49.35 +/- 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.


CONCLUSIONS
In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.
Chitapanarux
Taned
T
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. thaitaned@yahoo.com
Praisontarangkul
Ong-ard
OA
Thongsawat
Satawat
S
Pisespongsa
Pises
P
Leerapun
Apinya
A
D000293:Adolescent; D000328:Adult; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D012007:Rectum; D012307:Risk Factors; D013670:Sodium Pertechnetate Tc 99m
D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m