title: Diagnostic performance of using effervescent powder for detection and grading of esophageal varices by multi-detector computed tomography.
abstract: OBJECTIVE
  To investigate the effect of using effervescent powder (EP) on the efficacy of multi-detector computed tomography (MDCT) in detection and grading of esophageal varices in cirrhotic patients by considering endoscopy as the gold standard.
  
  
  METHODS
  Ninety-two cirrhotic patients undergoing biphasic liver MDCT followed by upper gastrointestinal endoscopy within 4 weeks of MDCT were prospectively evaluated. The patients were divided into two groups before MDCT. The first group (n=50) received effervescent powder (EP) before and during MDCT procedure and the second group did not receive (n=42). The presence, size and grade of the esophageal varices were evaluated. MDCT findings were compared with endoscopic results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of MDCT with EP and without EP were calculated and compared. Correlations between the grades of the varices for each group based on MDCT imaging and endoscopic grading were also evaluated.
  
  
  RESULTS
  The sensitivity, specificity, accuracy, PPV, and NPV of MDCT were 100%, 88%, 96%, 94%, and 100%, respectively, in the EP group, whereas they were 76%, 67%, 74%, 89%, and 43%, respectively, in the non-EP group. Correlations between the grades of the esophageal varices on MDCT and endoscopy were significant in both groups (r=0.94, p<0.001 for EP group and r=0.70, p<0.001 for non-EP group).
  
  
  CONCLUSIONS
  During periodic CT scanning of cirrhotic patients, use of EP increases the success rate of MDCT for detection and grading of esophageal varices.
authors.affiliation: Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey. Electronic address: drcansu@gmail.com.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Cansu
authors.affiliation: Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmetoglu
authors.affiliation: Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Kul
authors.affiliation: Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Gokcen
authors.initials: G
authors.lastname: Yukunc
authors.affiliation: Department of Gastroenterology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Fidan
authors.affiliation: Department of Gastroenterology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arslan
authors.affiliation: Department of Public Health, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Topbas
mesh_terms: D000284:Administration, Oral; D003287:Contrast Media / Q000008:administration & dosage; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013644:Tartrates / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D013644:Tartrates; D017693:Sodium Bicarbonate; C029768:tartaric acid
keywords: Cirrhosis; Computed tomography; Effervescent powder; Esophageal varices