Characteristics of paraesophageal varices: a study with 64-row multidetector computed tomography portal venography.
OBJECTIVE
To identify the characteristics of morphology, location and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomograghy (MDCT).


METHODS
Fifty-two of 501 patients with portal hypertensive cirrhosis accompanied with esophageal varices were selected for 64-row MDCT examination after the observation of para-EV. The CT protocol included unenhanced, arterial and portal phases with a slice thickness of 0.625 mm and a scanning field of 2 cm above the bifurcation to the lower edge of kidney. The CT portal venography (CTPV) was reformatted on AW4.3 workstation. The characteristics of origination, location, morphology and collateral circulation in para-EV were observed.


RESULTS
Among the 52 cases of para-EV, 50 showed the originations from the posterior branch of left gastric vein, while the others from the anterior branch. Fifty cases demonstrated their locations close to the esophageal-gastric junction, and the other two cases were extended to the inferior bifurcation of the trachea. The circuitous pattern was observed in 16 cases, while reticulated pattern was seen in 36 cases. Collateral circulation identified 4 cases of single periesophageal varices (peri-EV) communication, 3 cases of single hemiazygous vein, one case of single inferior vena cava, 41 cases of mixed type (collateral communications of at least 2 of above mentioned types) and 3 cases of undetermined communications. Among all the cases, 43 patients showed the communications between para-EV and peri-EV, while hemiazygous vein (43 cases) and inferior vena cava (5 cases) were also involved.


CONCLUSIONS
Sixty-four-row multidetector computed tomograghy portal venography could display the location, morphology, origin, and collateral types of para-EV, which provides important and referable information for clinical management and disease prognosis.
Zhao
Li-Qin
LQ
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'An Road, Xuan Wu District, Beijing 100050, China.
He
Wen
W
Chen
Guang
G
D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
Gastroenterology. 1988 Aug;95(2):434-40
3391371
J Gastroenterol Hepatol. 2001 May;16(5):495-500
11350543
Endoscopy. 2002 Feb;34(2):119-28
11822007
AJR Am J Roentgenol. 1999 Mar;172(3):651-4
10063853
Radiographics. 2002 Sep-Oct;22(5):1053-61
12235335
Med Arh. 2002;56(1 Suppl 1):11-2
12055714
J Gastroenterol. 2004;39(5):422-8
15175939
Gut. 1996 May;38(5):759-64
8707125
AJR Am J Roentgenol. 2007 Dec;189(6):W365-72
18029851
AJR Am J Roentgenol. 1998 Jun;170(6):1535-8
9609169
Fukushima J Med Sci. 2001 Dec;47(2):39-50
11989618
Gastrointest Endosc. 2002 Apr;55(4):512-7
11923763
Curr Treat Options Gastroenterol. 2002 Feb;5(1):73-80
11792240
Dig Surg. 2001;18(3):176-81
11464006
Gastrointest Endosc. 2002 Aug;56(2):249-53
12145605
Endoscopy. 2001 Feb;33(2):126-39
11272215
World J Gastroenterol. 2005 Aug 7;11(29):4560-5
16052688
Gastrointest Endosc. 1999 Sep;50(3):374-80
10462659
J Med Imaging Radiat Oncol. 2008 Feb;52(1):4-9
18373819
Hepatogastroenterology. 1996 Sep-Oct;43(11):1250-5
8908559
Hepatology. 1998 Sep;28(3):868-80
9731585
J Gastroenterol Hepatol. 1999 Mar;14(3):241-4
10197493