Portal Hypertensive Gastrointestinal Disease in Liver Cirrhosis: The Diagnostic Value of Contrast-Enhanced Multi-Slice Spiral CT.

OBJECTIVE

This study was designed to explore the diagnostic value of contrast-enhanced multi-slice spiral computed tomography (MSCT) in portal hypertensive gastrointestinal disease (PHGD) among patients with liver cirrhosis.

METHODS

A retrospective analysis was performed on cirrhotic patients admitted to our hospital from January 2020 to December 2024. Using endoscopic findings as the reference standard, these patients were divided into the PHGD group and the control group (non-PHGD group). Imaging parameters and serum markers were measured, and differences between the two groups were compared.

RESULTS

A total of 69 PHGD patients and 71 non-PHGD patients were enrolled. In the PHGD group, platelet count (PLT), hemoglobin (HB), and total protein (TP) were significantly lower than those in the non-PHGD group (P < 0.05). Regarding imaging indicators, portal vein diameter (PVD), superior mesenteric vein diameter (SMVD), splenic vein diameter (SVD), stomach wall thickness (SD), and stomach wall enhancement thickness (ST) in the PHGD group were significantly greater than those in the non-PHGD group (P < 0.05). The diagnostic efficacy of individual imaging parameters was moderate to good, with AUCs ranging from 0.742 to 0.880.

DISCUSSION: Contrast-enhanced MSCT parameters, particularly SMVD (AUC 0.880), PVD (AUC 0.852), and ST (AUC 0.849), demonstrated good diagnostic performance for identifying PHGD in cirrhotic patients. Imaging findings such as venous dilation, splenomegaly, gastrointestinal wall thickening, and ascites were significantly associated with PHGD, suggesting that MSCT may serve as a valuable non-invasive adjunctive tool when endoscopy is unavailable or inconclusive.

CONCLUSION

PHGD is a common and significant complication of portal hypertension, but there is a lack of standardized clinical diagnostic criteria. Contrastenhanced MSCT shows considerable potential in assisting the diagnosis of PHGD.