The value of portal vein imaging parameters of computer tomography in evaluating liver function grading and esophageal variceal bleeding risk in hepatitis B patients with cirrhosis

Abstract

Abstract: Objective To analyze the clinical value of computer tomography (CT) portal vein imaging parameters in evaluating liver function classification and esophageal variceal bleeding (EVB) risk in hepatitis B patients with cirrhosis. Methods From January 2020 to June 2023, sixty hepatitis B patients with cirrhosis were selected as the cirrhotic group(31 patients with gastrointestinal bleeding and 29 patients without bleeding). Fifty-four healthy people were selected in the same time period as the control group. CT portal vein imaging was used to measure the main portal vein (MPV), splenic vein (SPV), left gastric vein (LGV), left intrahepatic portal vein (IHLPV), and right intrahepatic portal vein (IHRPV) in the two groups; The diameters of portal and splenic veins with different Child Pugh grades in the cirrhotic patients were compared; The diameters of portal and splenic veins in the cirrhotic patients of gastrointestinal bleeding group and non-bleeding group were compared; The value of the diameters of portal and splenic veins in predicting EVB in cirrhotic patients were analyzed by reciever operating characteristic curve (ROC) method. Results The diameters of MPV, LGV, SPV, IHRPV and IHLPV in the hepatitis B cirrhosis group were (1.8 ± 0.5) cm, (1.5 ± 0.4) cm, (1.4 ± 0.3) cm, (1.4 ± 0.4) cm and (1.2 ± 0.3) cm, respectively, which were significantly higher than those in the control group [(1.1 ± 0.2) cm, (0.6 ± 0.1) cm, (0.8 ± 0.2) cm, (0.7 ± 0.2) cm and (0.6 ± 0.2) cm, respectively, P<0.05]; The diameters of MPV, LGV, SPV, IHRPV and IHLPV in Child-Pugh grade A patients were (1.9 ± 0.4) cm, (1.6 ± 0.4) cm, (1.5 ± 0.4) cm, (1.4 ± 0.4) cm and (1.3 ± 0.4) cm, respectively, which were significantly lower than those of [(2.5 ± 0.5) cm, (1.9 ± 0.3) cm, (1.8 ± 0.5) cm, (1.8 ± 0.6) cm and (1.8 ± 0.4) cm, P<0.05] in Child-Pugh grade B patients. and those of [(2.7 ± 0.7) cm, (2.3 ± 0.6) cm, (2.2 ± 0.6) cm, (2.2 ± 0.7) cm, (2.2 ± 0.7) cm in Child-Pugh C,patients [ P<0.05]; The diameter of IHRPV in the gastrointestinal bleeding group [(1.6 ± 0.4) cm] was significantly higher than that in the non-bleeding group [(1.5 ± 0.3) cm] (P>0.05). The diameters of MPV, LGV, SPV and IHLPV in the gastrointestinal bleeding group were (2.4 ± 0.7) cm, (2.1 ± 0.5) cm, (1.7 ± 0.5) cm and (1.7 ± 0.4) cm, respectively, which were significantly higher than those of (1.6 ± 0.4) cm, (1.2 ± 0.3) cm, (1.3 ± 0.3) cm and (1.1 ± 0.5) cm in the control group (P<0.05); ROC analysis confirmed that the diameters of portal and splenic veins could predict the occurrence of EVB in patients with hepatitis B cirrhosis, and the areas under the curves (AUC) of MPV, LGV, SPV and IHLPV were 0.815, 0.841, 0.829, 0.813, respectively, with all P<0.05. Conclusion CT portal vein imaging can clearly reflect the collateral circulation of portal hypertension in hepatitis B patients with cirrhosis, and the diameters of its trunks and branches has clinical value in predicting the occurrence of EVB.

Key words: CT portal vein imaging, Hepatitis B related cirrhosis, Liver function grading, Rupture and bleeding of esophageal varices

HUANG Ya-bo, YANG Ying, WANG Jin-jun. The value of portal vein imaging parameters of computer tomography in evaluating liver function grading and esophageal variceal bleeding risk in hepatitis B patients with cirrhosis[J]. Chinese Hepatolgy, 2024, 29(2): 162-165.

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