Clinically severe portal hypertension: role of multi-detector row CT features in diagnosis.
OBJECTIVE
To explore the CT signs which permit estimation of clinically severe portal hypertension (PH) [≥ 12 of hepatic vein pressure gradient (HVPG)].


METHODS
One-hundred and seven consecutive patients who underwent HVPG measurement in the PH group and 52 controls were included. The diameters of main portal vein (øMPV), superior mesenteric vein (øSMV), splenic vein (øSV), and left gastric vein, øMPV/øSV, øSMV/øSV, as well as estimated spleen volumes were evaluated on the CT scan. The grade of varix and ascites were also evaluated semi-quantitatively. We explored the statistically significant CT features related to severe PH and performed a logistic regression analysis for an estimation model for severe PH.


RESULTS
øMPV/øSV and øSMV/øSV tended to gradually increase as the PH became severer, and the difference between severe and not severe groups was statistically significant (p = 0.015 and 0.038, respectively). According to the regression analysis, øSMV/øSV and the grade of esophageal varix and ascites were finally included as related variables for predicting severe PH. The odds ratio (OR) of øSMV/øSV was 4.596, and large esophageal varix (OR 4.135) and mild (OR 3.051) and large amount of ascites (OR 21.781) were statistically significantly related to severe PH.


CONCLUSIONS
Changing diameters of portal system, the grades of esophageal varices and ascites on multi-detector row computed tomography might be indicative features for clinically severe PH.
Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyeongchun-ro 153, Guri-si, Gyeonggi-do, 471-701, Republic of Korea.
Ji Young
JY
Lee
Tae Yeob
TY
Kim
Woo Kyoung
WK
Jeong
Yongsoo
Y
Kim
Jinoo
J
Kim
Kyoung Won
KW
Kim
Young Hwan
YH
Kim
Joo Hyun
JH
Sohn
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology; D001794:Blood Pressure; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000145:classification* / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011169:Portal Vein / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013162:Splenic Vein / Q000000981:diagnostic imaging; D055815:Young Adult