Usefulness of CT volumetry for gastric varix before balloon-occluded retrograde transvenous obliteration.

BACKGROUND/AIMS: To evaluate the feasibility of gastric variceal (GV) volumetry using computed tomography (CT) images taken before balloon-occluded retrograde transvenous obliteration (B-RTO) and to assess its correlation with the actual amount of 5% ethanolamine oleate and iodinated contrast medium (EOI) injected in B-RTO.

METHODOLOGY: Forty-seven consecutive patients with GV underwent B-RTO of the gastrorenal shunt. GV volume was measured with preoperative CT images by three radiologists. Statistical significance was examined by intraclass correlation coefficient (ICC) for concordance among three radiologists and by Pearson correlation test for correlation between GV volume and the amount of 5% EOI injected.

RESULTS: GV volumes measured by three radiologists significantly correlated with each other (ICC=0.959). Combining all patients and all measurements, the mean GV volume and the mean amount of 5% EOI were 27.02±16.67cm3 and 28.72±17.72mL, respectively. There was a significant correlation between GV volume, calculated as a mean of the three values measured by the three radiologists, and the amount of EOI (r2=0.706, p<0.001).

CONCLUSIONS: GV volume measured on CT showed a significant correlation with the amount of 5% EOI injected. CT volumetry of GV has the potential to determine an amount of the sclerosing agent to be injected in B-RTO.