Abstract: Objective The aim of this study was to explore CT portography (CTP) quantitative parameters in predicting portal hypertension and esophagogastric variceal bleeding (EVB) in patients with decompensated liver cirrhosis (DLC). Methods A total of 98 patients with decompensated hepatitis B-induced liver cirrhosis were encountered in our hospital between January 2021 and March 2023, and all underwent CTP, gastroscopy and portal pressure gradient (PPG) determination. Patients were followed-up for 12 months, and receiver operating characteristic (ROC) curve was applied to evaluate predictive performance. Results Of 98 patients with liver cirrhosis in our series, esophagogastric varices (EV) was found in 47 cases(48.0%) and significant portal hypertension (SPH) in 45 cases (45.9%); diameters of main portal vein, splenic vein, left gastric vein, left branch and right branch of intrahepatic portal vein in patients with SPH were (17.6±1.8)mm, (15.9±1.9)mm, (6.1±1.3)mm, (13.0±1.3)mm and (12.6±1.7)mm, all significantly greater than [(14.9±2.0)mm, (14.0±2.0)mm, (4.6±1.6)mm, (11.3±1.4)mm and (11.3±1.6)mm, respectively, P＜0.05] in those with non-SPH(NSPH); during 12-month follow-up, EVB occurred in 22 cases (22.5%), and baseline diameters of five portal veins mentioned above in patients with EVB were all much greater than in those without EVB(P＜0.05); the AUC was 0.830(P＜0.05), with sensitivity (Se) of greater than 75.6% and specificity (Sp) of greater than 79.3%, or the AUC was 0.755(P＜0.05, with Se of greater than 68.2% and Sp of greater than 71.1% in predicting SPH or EVB when any combination of three parameters from the five was met. Conclusion CTP quantitative parameters have certain clinical diagnostic efficacy in predicting SPH and EVB in cirrhotic patients, and needs further investigation.

Key words: Liver cirrhosis, Portal hypertension, Esophagogastric variceal bleeding, CT portography, Diagnosis