title: Computed tomography indices and criteria for the prediction of esophageal variceal bleeding in survivors of biliary atresia awaiting liver transplantation.
abstract: OBJECTIVE
  About 20% of biliary atresia (BA) survivors have attacks of esophageal variceal bleeding. We propose a method to evaluate the risk of esophageal variceal bleeding (EVB) using noninvasive indices by multislice computed tomography (CT).
  
  
  METHODS
  We reviewed 31 potential living-related liver recipients aged 99-5314 days (mean, 1474 days) who underwent CT examinations using a 64-slice multislice CT scanner. Of the 31 patients, 19 patients (Group A) with fecal occult blood had EVB on esophagogastroduodenoscopy; the rest belonged to Group B. Splenic diameters (mm) were divided by body heights (m) and platelet counts (1000/mm(3)) to produce standardized ratios of transverse splenic length/body height/platelet count (SLHPR). The transverse diameters of paraesophageal veins (PVs) and perigastric veins (PGVs) were measured adjacent to the lower thoracic esophagus and within the lesser sac, respectively.
  
  
  RESULTS
  According to a receiver operating characteristic curve analysis, the SLHPRs (r=0.833), transverse PV (r=0.957), and PGV (r=0.987) diameters were better predictors of EVB than demographic and laboratory variables. However, the transverse diameters of PGVs and PVs were the most accurate predictors of the EVB.
  
  
  CONCLUSIONS
  For candidates awaiting liver transplantation, screening by noninvasive SLHPR and the transverse diameters of PGVs and PVs by CT may help to identify BA patients with a high risk of EVB.
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and Medical School, Taipei, Taiwan, ROC.
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Yang
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Ming Chih
authors.initials: MC
authors.lastname: Ho
authors.forename: Steven
authors.initials: S
authors.lastname: Shinn-Forng Peng
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging*; D016031:Liver Transplantation; D008297:Male; D061330:Multidetector Computed Tomography; D009780:Occult Blood; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D013154:Spleen / Q000000981:diagnostic imaging*