Role of CT Portography in Detection of Portosystemic Collaterals in Patients with Portal Hypertension

CT and CT portography become the tools of investigation of the liver and the portosystemic varices by drawing their course to avoid bleeding which could be life threatening, and in major operations such as liver transplantation. Aim of the Work: to draw portosystemic collaterals associated in portal hypertension by CT Portography imaging. Patients and Methods: In this study we have assessed 20 cases in 6 months at the Ain Shams university hospitals, where they subjected to full history sheeting, full clinical examination, MDCT portography and to the upper GI endoscopy. Results:There is significant correlation between portal vein diameter and sites of collaterals, as the sites of collaterals increase when the diameter of the portal vein decreases. Regarding to the CT findings and their comparison with the upper GI endoscopy findings was found that all the cases that were positive for gastro-esophageal collaterals in CT were also positive for gastro-esophageal collaterals in the upper GI endoscopy, which is meaning that the CT is very good excluded modality with 100% sensitivity. While the CT was upgrading for 2 cases from 20 cases in gastric varices (10%), 3 cases from 20 cases(15%) in esophageal varices, which is meaning that CT has 89 %, 82 % specificity in grading the gastric and esophageal collaterals respectively . Conclusion: MDCT portography is an important imaging modality in assessment the portal vein, the resulting portosystemic collaterals. It is very good screening modality for any suspected varices as it has 100 % sensitivity.