Abstract: Objective To investigate the value of CT-detected portal parameters in the diagnosis ofsignificant clinical portal hypertension (SCPH) and predictingesophageal and gastric variceal bleeding in patients with hepatitis B cirrhosis. Methods 62 patients with hepatitis B liver cirrhosis were admitted to our hospital from May 2016 to November 2019, and all patients received CT examination having relevant portal parameters recorded. The hepatic vein pressure gradient (HVPG) was detected. The receiver operating characteristic curve (ROC) were applied to analyze CT-related parameters to diagnose SCPH when the HVPG was acted as the gold standard, and to predict bleeding of esophageal and gastric varices. Results There were 27 patients having SCPH in our series; the total liver volume in this 27 patient with SCPH was (1015.7±162.8)cm³, significantly smaller than [(1174.2±204.5)cm³,P<0.05] in 35 patients without SCPH, the spleen volume was (852.±264.3) cm³, significantly larger than [(593.9±303.4) cm³, P<0.05],the width of portal vein was (1.2±0.2)cm, significantly wider than [(1.0±0.3) cm³, P<0.05)], and the width of splenic vein was (1.1±0.2) cm, significantly wider than [(0.9±0.2)cm, P<0.05] in patients without SCPH; the ROC analysis showed that the spleen volume (AUC=0.742,the sensitivity = 0.778), the whole liver volume (AUC = 0.802, sensitivity = 0.809), the portal vein width (AUC = 0.777, sensitivity = 0.815) and spleen vein width (AUC = 0.708, sensitivity = 0.815) had good value in the diagnosis of SCPH (P<0.05), and that the spleen volume (AUC = 0.727, sensitivity = 0.882), the whole liver volume (AUC = 0.686, sensitivity = 0.765), the portal vein width (AUC = 0.684, sensitivity = 0.824) and the spleen vein width (AUC = 0.787, sensitivity = 0.771) had higher sensitivity to forecast the esophageal and gastric variceal bleeding (P<0.05). Conclusion The portal parameters by CT scan in patients with hepatitis B cirrhosis are closely related to HVPG, and they might be helpful for the diagnosis of SCPH and judgement of esophageal and gastric variceal bleeding in clinical practice.

Key words: Liver cirrhosis, Significant clinical portal hypertension, CT scan, Portal parameters, Hepatic vein pressure gradient, Esophageal variceal bleeding