Comparative Study of Esophageal Varices Grading by Multi-Detector Computed Tomography and Endoscopy

Abstract Background: Cirrhosis is often complicated by Esophageal Varices (EV) and portal hypertension. The use of upper GI endoscopy (GIE) as a screening method is limited regarding invasiveness, expensive, needs sedation as well as patient's poor acceptance of the procedure. In contrast; Multidetector Computed Tomography (MDCT) imaging is non-invasive, does not necessitate sedation, and allows accurate assessment of variceal site and size, also better tolerated by patients than upper GI Endoscopy (GIE). Aim of Study: To prove that MDCT is a non-invasive alternative diagnostic tool to EGD in grading of Esophageal Varices. Patients and Methods: 50 patients with liver cirrhosis were included. Evaluation of Multidetector Computed Tom-ography (MDCT) in the diagnosis of esophageal varices and its grading was done by comparing the grades of Esophageal Varices at Multidetector Computed Tomography (MDCT) and upper GI endoscopy independently. Extra-esophageal findings were also assessed by Multidetector Computed Tomography (MDCT) that cannot by (GIE). Results: At upper GI endoscopy, 3 patients had grade 0 Esophageal Varices, 25 patients had grade 1, 16 patients had grade 2 and 6 had grade 3. The sensitivity, specificity, positive and negative predictive values and accuracy of Multidetector Computed Tomography (MDCT) for defining Esophageal Varices in all grades were 99.5%, 99.6%, 99.4%, 99.5% and 99.5% respectively. Important extra-esophageal findings were determined by Multi-Detector Computed Tomography (MD-CT) only. The acceptance of patients for Multidetector Com-puted Tomography (MDCT) was significantly more than that for upper GI Endoscopy (GIE). Conclusion: Multi-Detector Computed Tomography (MD-CT) is a fast, non-invasive procedure for diagnosis and grading of Esophageal Varices.