Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;50(7):2783-2793.
doi: 10.1007/s00261-024-04666-1. Epub 2024 Nov 15.

Assessment of high-risk gastroesophageal varices in cirrhotic patients using quantitative parameters from dual-source dual-energy CT

Qixuan Qiu  1 , Yingjie Ai  2 , Yijun Pan  1 , Wei Luo  1 , Zhihan Xu  3 , Shiyao Chen  2 , Jiang Lin  4
Affiliations

Assessment of high-risk gastroesophageal varices in cirrhotic patients using quantitative parameters from dual-source dual-energy CT

Qixuan Qiu et al. Abdom Radiol (NY). 2025 Jul.

Abstract

Purpose: To investigate the clinical value of dual-source dual-energy CT (dsDECT) quantitative parameters in evaluating hemodynamics and predicting high-risk gastroesophageal varices in cirrhotic patients.

Methods: 98 consecutive patients were collected in this prospectively study and all patients underwent an abdominal triple-phase contrasted-enhanced examination with dsDECT. Iodine concentration (IC) and normalized iodine concentration (NIC) of the liver parenchyma, spleen parenchyma and aorta at different phases were recorded, and arterial iodine fraction (AIF), iodine washout rate (IWR), and extracellular volume (ECV) were calculated. Using upper gastrointestinal endoscopy as the reference standard, patients who met the inclusion and exclusion criteria were divided into groups with varices need treatment (VNT) and non-VNT. The clinical characteristics, traditional CT features and quantitative dsDECT parameters were compared between the VNT group and the non-VNT group using univariate analysis. The binary logistics analysis was used to build a model for diagnosing VNT. The receiver operating characteristic (ROC) curve was used for analysis and the DeLong test was used to compare different ROC curves.

Results: Finally, 57 patients were included in this study. Univariate analysis showed statistically significant differences in NIC of the liver at the portal venous phase (NIC-LPVP), IWR of the liver (IWR-L) and spleen volume between the VNT group and the non-VNT group (p < 0.05). The mixed-CT model was built by binary logistics analysis. The ROC curves of NIC-LPVP, IWR-L, spleen volume and the mixed-CT model were statistically significant (p < 0.05) for predicting VNT in cirrhotic patients, among which the area under the ROC curve of the mixed-CT model was the highest.

Conclusion: Dual-source dual-energy CT has added clinical value in evaluating hepatic hemodynamics and diagnosing VNT in patients with liver cirrhosis.

Keywords: Dual-energy CT; Gastroesophageal varices; Liver cirrhosis; Portal hypertension.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. D’Amico G, Garcia-Pagan JC, Luca A, Bosch J. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology. 2006;131(5):1611–24. Epub 2006/11/15. https://doi.org/10.1053/j.gastro.2006.09.013 . PubMed PMID: 17101332. - DOI - PubMed
    1. Hernandez-Gea V, Berbel C, Baiges A, Garcia-Pagan JC. Acute variceal bleeding: risk stratification and management (including TIPS). Hepatol Int. 2018;12(Suppl 1):81–90. Epub 2017/06/22. https://doi.org/10.1007/s12072-017-9804-3 . PubMed PMID: 28634688. - DOI - PubMed
    1. Nardelli S, Riggio O, Turco L, Gioia S, Puzzono M, Bianchini M, et al. Relevance of Spontaneous Portosystemic Shunts Detected with CT in Patients with Cirrhosis. Radiology. 2021;299(1):133–40. Epub 2021/02/03. https://doi.org/10.1148/radiol.2021203051 . PubMed PMID: 33529134. - DOI - PubMed
    1. Yan C, Han X, Liang X, Jia J, Xu Y, Zhao L. Non-invasive evaluation of esophageal varices in patients with liver cirrhosis using low-dose splenic perfusion CT. Eur J Radiol. 2022;152:110326. Epub 2022/05/04. https://doi.org/10.1016/j.ejrad.2022.110326 . PubMed PMID: 35504216. - DOI - PubMed
    1. Mesropyan N, Isaak A, Faron A, Praktiknjo M, Jansen C, Kuetting D, et al. Magnetic resonance parametric mapping of the spleen for non-invasive assessment of portal hypertension. Eur Radiol. 2021;31(1):85–93. Epub 2020/08/05. https://doi.org/10.1007/s00330-020-07080-5 . PubMed PMID: 32749584; PubMed Central PMCID: PMCPMC7755629. - DOI - PubMed