Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

The purpose of this study was to discuss the role of CT portography in detection of porto-systemic collaterals in portal hypertension and to find out a non-invasive alternative to the upper GI endoscopy for detection of the high risk esophageal varices as prophylaxis and follow up of the banded esophageal varices. Thirty(30) patients diagnosed as portal hypertension from E.R and inpatient sections of internal medicine department (31), Kasr Alaini hospitals, Cairo university and from national hepatology and tropical medicine research Institute of Cairo, were subjected to MDCT portography via helical CT scanner. Fifty (15) patients out of the 30 patients who have recent or old history of hematemesis underwent also endoscopic examination either for detection or for follow up and also for comparison. Six (6) patients out of those fifty underwent previous esophageal varices band ligationand nine (9) patients are naïvei.e no previous intervention for loco-regional treatment. Thin, axial sections and three dimensional (3-D) reconstructions, including maximum intensity projection (MIP) and Volume rendering (VR), were obtained. The findings of hematemesis patients (15) cases, in correlation with their upper GI endoscopy for GOV, were: The 9 naïve cases, 7 cases were positive for esophageal varices (OV) and 5 cases were positive for gastric varices (GV) in both modalities with 100% sensitivity of CT in detection of high risk esophageal varices category and the no esophageal varices category but inaccurate grading of the zone in-between as CT showed upgrading of 22.2% of cases from the studied naïve cases from the low/probably high risk by endoscopy into the high risk category by CT

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