title: Multidetector computed tomography versus platelet/spleen diameter ratio as methods for the detection of gastroesophageal varices.
abstract: BACKGROUND
  All patients with liver cirrhosis should undergo screening endoscopy, but there are limitations and this approach places a heavy burden upon endoscopy units. The aim of this study was to compare multidetector computed tomography (MDCT) and the platelet/spleen diameter ratio as non-invasive methods for the detection of gastroesophageal varices.
  
  
  METHODS
  The study included 38 cirrhotics who underwent upper gastrointestinal (GI) endoscopy and MDCT within one month. Two radiologists reviewed the scans, in order to determine the presence and the size of varices. Blood tests and measurement of the spleen maximum diameter were also carried out and the platelet/spleen diameter ratio was calculated. Endoscopy was considered the gold standard and the results of the two methods were compared to it.
  
  
  RESULTS
  Varices were detected by upper GI endoscopy in 24 of 38 patients. The mean sensitivity and specificity of MDCT for the two observers was 86.1% and 57.1% respectively. In patients with large varices (>5 mm), the sensitivity was 100% (4/4). Using 909 as a cut-off value of the platelet/spleen diameter ratio this method yielded a sensitivity of 56.5% and a specificity of 35.7%. The difference in sensitivity and specificity between the two methods was statistically significant P<0.05.
  
  
  CONCLUSIONS
  MDCT was accurate for the detection of gastroesophageal varices, especially those with clinically significant size (>5 mm), and superior to platelet/spleen diameter ratio. MDCT could replace, in selected patients, upper GI endoscopy as a method for detecting gastroesophageal varices in cirrhotic patients.
authors.affiliation: Department of Radiology (Andreas Karatzas, Theodoros Petsas, Christina Kalogeropoulou).
authors.forename: Andreas
authors.initials: A
authors.lastname: Karatzas
authors.affiliation: Department of Gastroenterology (Christos Triantos, Maria Kalafateli, Misiel Marzigie, Konstantinos Thomopoulos).
authors.forename: Christos
authors.initials: C
authors.lastname: Triantos
authors.affiliation: Department of Gastroenterology (Christos Triantos, Maria Kalafateli, Misiel Marzigie, Konstantinos Thomopoulos).
authors.forename: Maria
authors.initials: M
authors.lastname: Kalafateli
authors.affiliation: Department of Gastroenterology (Christos Triantos, Maria Kalafateli, Misiel Marzigie, Konstantinos Thomopoulos).
authors.forename: Misiel
authors.initials: M
authors.lastname: Marzigie
authors.affiliation: Department of Internal Medicine (Chryssouls Labropoulou-Karatza), University Hospital of Patras, Rion, Patras, Greece.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Labropoulou-Karatza
authors.affiliation: Department of Gastroenterology (Christos Triantos, Maria Kalafateli, Misiel Marzigie, Konstantinos Thomopoulos).
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Thomopoulos
authors.affiliation: Department of Radiology (Andreas Karatzas, Theodoros Petsas, Christina Kalogeropoulou).
authors.forename: Theodoros
authors.initials: T
authors.lastname: Petsas
authors.affiliation: Department of Radiology (Andreas Karatzas, Theodoros Petsas, Christina Kalogeropoulou).
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogeropoulou
keywords: Varices; endoscopy; multidetector computed tomography; platelet/spleen ratio