The diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices

In Tanzania, triphasic abdominal Computed Tomography (CT) is a more accessible and non-invasive alternative for diagnosing esophageal varices, though its accuracy has not been thoroughly evaluated, therefore this study aimed to determine the diagnostic accuracy of triphasic abdominal CT in detecting...

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Bibliographic Details
Published in:	BMC medical imaging Vol. 24; no. 1; pp. 214 - 5
Main Authors:	Lukoo, Suzana, Musa, Balowa, Salingwa, Lilian, Mpemba, Gerard, Jusabani, Ahmed
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 14-08-2024 BioMed Central BMC
Subjects:	Abdomen Accuracy Adult Aged Ascites Bleeding Clinical outcomes Computed tomography Cross-Sectional Studies CT imaging Developing countries Diagnostic imaging Diagnostic systems Endoscopy Endoscopy, Digestive System - methods Esophageal and Gastric Varices - diagnostic imaging Esophageal carcinoma Esophageal varices Esophagus Female Fibrosis Gastrointestinal Hemorrhage - diagnostic imaging Hepatitis Hepatocellular carcinoma Humans Hypertension Invasiveness LDCs Liver cancer Liver cirrhosis Liver diseases Male Medical imaging Middle Aged Mortality Oesophagoduodenoscopy Patients Predictive Value of Tests Sensitivity and Specificity Tanzania Thromboembolism Thrombosis Tomography Tomography, X-Ray Computed - methods Triphasic abdominal CT Varicose veins Tanzania Pakistan Oesophagoduodenoscopy Esophageal varices Triphasic abdominal CT
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Summary:	In Tanzania, triphasic abdominal Computed Tomography (CT) is a more accessible and non-invasive alternative for diagnosing esophageal varices, though its accuracy has not been thoroughly evaluated, therefore this study aimed to determine the diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices using esophagogastroduodenoscopy (OGD) as the gold standard among patients with upper gastrointestinal bleeding at Muhimbili National Hospital (MNH). This cross-sectional study was conducted at MNH from January 2021 to May 2023. We sampled upper gastrointestinal bleeding patients who underwent both OGD and triphasic abdominal CT using non-probability consecutive sampling. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of triphasic abdominal CT were assessed against OGD findings. In a study of 200 participants, esophageal varices were detected in 54% by OGD and 53.5% by CT. We observed 105 true positives, 2 false positives, 90 true negatives, and 3 false negatives. Triphasic abdominal CT demonstrated a sensitivity of 97.2%, specificity of 97.8%, PPV of 98.1%, NPV of 96.8%, and an accuracy of 97.5%. Extraluminal findings included portal venous thrombosis in (22%), splenic collateral (51.5%), ascites (32%), hepatocellular carcinoma (13%), and periportal fibrosis (32%). Triphasic abdominal Computed Tomography can be used as a reliable and non-invasive alternative modality for diagnosing and screening esophageal varices in resource-limited settings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2342 1471-2342
DOI:	10.1186/s12880-024-01388-0