能谱CT联合肝脏体积评估肝硬化并发食管静脉曲张价值研究*

doi:10.3969/j.issn.1672-5069.2026.04.025

Abstract

Abstract: Objective The aim of this study was to assess esophageal varices (EV) by spectral CT parameters in patients with hepatitis B-induced liver cirrhosis (LC). Methods 67 patients with hepatitis B-induced LC were encountered in our hospital between January 2024 and June 2025, and all patients underwent gastroscopy that found high risk EV in 34 cases and low-risk EV in 33 cases. Abdominal spectral CT scan was performed to record liver iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number (Zeff) and spectral curve slope (λHU), total liver volume (TLV), standardized liver volume (SLV), functional liver volume (FLV) and FLV/body surface area (BSA) (FLV/BSA) ratio was calculated. Multivariate Logistic regression analysis was applied to find impacting factors. Results Percentages of Child-Pugh class C and splenomegaly, MELD score, total serum bilirubin and INR in patients with high-risk EV were all significantly greater or higher than (P<0.05), while platelet count and serum albumin level were significantly lower than in those with low-risk EV (P<0.05); IC, NIC, Zeff and λHU were (1.4±0.3)mg/ml, (0.4±0.1), (7.3±0.2) and (1.4±0.4), all much smaller than [(1.6±0.3)mg/ml, (0.5±0.1), (7.7±0.2) and (1.6±0.4), respectively, P<0.05] in patients with low-risk EV; TLV, SLV, FLV and FLV/BSA ratio were (1086.2±205.6)ml, (664.8±103.5)ml/m², (958.3±183.4)ml and (585.3±94.1)ml/m², all much smaller than [(1243.6±221.4)ml, (731.6±110.8)ml/m², (1114.2±198.1)ml and (654.3±101.7)ml/m², respectively, P<0.05] in those with low-risk EV; multivariate Logistic regression analysis showed that Child-Pugh classification, PLT count, IC, NIC, Zeff and FLV were all the independent risk factors for high-risk EV occurrence (P<0.05); by end of one-year follow-up, EV bleeding (EVB) happened in 12 cases in our series, of which 11 patients (32.4%) in high-risk EV and 1 (3.0%, P<0.05) in those with low-risk EV. Conclusion Spectral CT quantitative parameters, including liver volume measurement, could help predict EV or even EVB risk in patients with LC, and an appropriate preventive measures should be given to improve the prognosis.

Key words: Liver cirrhosis, Esophageal varices, Spectral computed tomography, Liver iodine concentration, Normalized iodine concentration, Effective atomic number, Spectral curve slope, Total liver volume, Standardized liver volume

Chen Ling, Liu Hong, Zhang Xinling, et al. Assessment of esophageal varices by spectral CT parameters in patients with hepatitis B-induced liver cirrhosis[J]. Journal of Practical Hepatology, 2026, 29(4): 577-580.

References

[1] Fadlallah H, El Masri D, Bahmad HF, et al. Update on the complications and management of liver cirrhosis. Med Sci (Basel), 2025, 13(1):13.
[2] Tapper EB, Goldberg D, Parikh ND, et al. The liver cirrhosis network cohort study: Cirrhosis definition, study population, and endpoints. Am J Gastroenterol, 2025, 120(3):570-575.
[3] Ko D, Kim DH, Danpanichkul P, et al. Liver cirrhosis in metabolic dysfunction-associated steatohepatitis. Gastroenterol Rep (Oxf), 2025, 13:goaf037.
[4] Singh S, Chandan S, Vinayek R, et al. Comprehensive approach to esophageal variceal bleeding: From prevention to treatment. World J Gastroenterol, 2024, 30(43):4602-4608.
[5] Elhendawy M, Elkalla F. Computed tomography for prediction of esophageal variceal bleeding. World J Gastrointest Endosc, 2024, 16(3):175-177.
[6] Zhang YH, Hu B. Future directions of noninvasive prediction of esophageal variceal bleeding: No worry about the present computed tomography inefficiency. World J Gastrointest Endosc, 2024, 16(3):108-111.
[7] Fu S, Chen D, Zhang Z, et al. Predictive value of spectral computed tomography parameters in esophageal variceal rupture and bleeding in cirrhosis. Turk J Gastroenterol, 2023, 34(4):339-345.
[8] Liu H, Sun J, Liu G, et al. Establishment of a non-invasive prediction model for the risk of oesophageal variceal bleeding using radiomics based on CT. Clin Radiol, 2022, 77(5):368-376.
[9] Yang LB, Zhao G, Tantai XX, et al. Non-invasive model for predicting esophageal varices based on liver and spleen volume. World J Clin Cases, 2022, 10(32):11743-11752.
[10] Tan BG, Tang Z, Ou J, et al. A novel model based on liver/spleen volumes and portal vein diameter on MRI to predict variceal bleeding in HBV cirrhosis. Eur Radiol, 2023, 33(2):1378-1387.
[11] Furuichi Y, Nishiguchi R, Sato K. Scoring system for prediction of mortality after endoscopic ligation in esophageal variceal bleeding. Dig Endosc, 2024, 36(10):1115-1117.
[12] Zhang YH, Hu B. Future directions of noninvasive prediction of esophageal variceal bleeding: No worry about the present computed tomography inefficiency. World J Gastrointest Endosc, 2024, 16(3):108-111.
[13] Kim BK, Kim JS, Lee HJ, et al. Low-versus high-concentration iodine contrast for hepatic multiphase CT in chronic liver disease: Image quality, lesion detectability, and iodine load reduction with modern MDCT-A retrospective non-inferiority study. Diagnostics (Basel), 2025, 15(23):3026.
[14] Kim JE, Lim Y, Kim JS, et al. Image quality and lesion detectability with low-monoenergetic imaging: A study of low-concentration iodine contrast in hepatic multiphase CT for chronic liver disease. Tomography, 2025, 11(6):66.
[15] Celestino A, Marra P, Barbaro A, et al. Correlation of spectral CT-based iodine concentration parameters with LI-RADS classification of suspected hepatocellular carcinoma nodules in cirrhotic patients. Diagnostics (Basel), 2025, 15(6):725.
[16] Zhang J, Zhang K, Du T, et al. Dual-energy CT biomarkers for predicting the efficacy of TACE combined with lenvatinib and immune checkpoint inhibitors in unresectable HCC. Eur Radiol Exp, 2026, 10(1):4.
[17] Wan S, Wei Y, Zhang X, et al. CT-derived quantitative liver volumetric parameters for prediction of severe esophageal varices and the risk of first variceal hemorrhage. Eur J Radiol, 2021, 144:109984.
[18] Zhao Q, Zi Q, Dong G, et al. Clinical efficacy of transjugular intrahepatic portosystemic shunt in treating esophageal variceal bleeding in patients with liver cirrhosis. Pak J Med Sci, 2025, 41(4):1138-1144.
[19] Weil D, Clément M, Bouzbib C, et al. Improved survival in patients with refractory variceal bleeding treated with esophageal stents: A multicenter cohort study. JHEP Rep, 2025, 7(12):101581.
[20] Nguyen KP, Nguyen XV, Doan TH. Impact of timing of endoscopy on clinical outcomes in cirrhotic patients with esophageal variceal bleeding: a monocentric retrospective study from Vietnam. BMC Gastroenterol, 2025, 25(1):565.

Assessment of esophageal varices by spectral CT parameters in patients with hepatitis B-induced liver cirrhosis

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