Diagnostic Accuracy of Multi-Detector Computed Tomography Esophagography in Grading of Esophageal Varices in Cirrhotic Patients

Abstract

Objective: To assess the diagnostic accuracy of computed tomography esophagography in grading esophageal varices using upper gastrointestinal endoscopy as a gold standard. Study Design: Cross-sectional (validation) study Place and Duration of Study: Radiology department, Holy Family Hospital, Rawalpindi from 14th July 2016 to 13th January 2017. Methodology: One hundred and forty five clinically diagnosed patients of liver cirrhosis, age between 35-80 years were enrolled in this study. All patients underwent multi-detector computed tomography and endoscopy examination for the identification as well as grading of oesophageal varices. Results: High risk varices were identified in 106 (73.1%) of patients on multi-detector computed tomography and were identified in 108 (74.5%) of patients on endoscopy. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy of multi-detector computed tomography forthe identification of high risk esophageal varices were found to be 94.4%, 89.2%, 84.6%, 96.2% and 93.1% respectively. Conclusion: Multi-detector computed tomography esophagography detected high risk esophageal varices with excellent accuracy. This could be a practical and non-invasive choice of imaging for the identification& grading of esophageal varices. Key words: Esophageal varices, Multi-detector computed tomography (MDCT), Endoscopy