A comparative study on the diagnosis and the therapeutic evaluation of gastric varices between CT portal angiography and endoscopy

Objective To investigate the diagnosis!of portal hypertension and gastric varices(GV) by CT portal angiographies and to evaluate the efficacy of endoscopically the sclerotherapy of adhesives combined with sclerosants in gastric varices.Method Twenty patients with gastric varices were endoscopically diagnosed and treated with adhensives and sclerants.All of them underwent CT portal angiography before and after the treatment.Results The CT portal angiography revealed all the patients had the gastric varices.According to Sarin's category of GV,gastroesophageal varices GOV-1,in which the predominant route to form the varices was the left gastric vein.GOV-2,in which the left gastric vein and the posterior/short gastric veins contributed to the formation of the varices.Isolated gastric varices IGV-1,in which posterior/short gastric veins were the major contributors to form the varices and the rate of gastorenal shunt was relatively high.After the endoscopically the sclerotherapy of adhesives combined with sclerosants,the overall efficient rate was 90.00% in 10 patients with IGV-1 and 44.45% in 9 patients with GOV-1 or GOV-2.Conclusions The CT portal angiography is considered as a routine method for detecting and assessing portosystemic collaterals.It is also useful for selecting patients as candidates,and for evaluating the therapeutic results.