Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4277-4286
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4277
Portal vein computed tomography imaging characteristics and their relationship with bleeding risk in patients with liver cirrhosis undergoing interventional therapy
Xue-Jing Song, Jing-Lei Liu, Shu-Ya Jia, Kai Zhang
Xue-Jing Song, Kai Zhang, Department of Medical Oncology, Shijiazhuang People’s Hospital, Shijiazhuang 050000, Hebei Province, China
Jing-Lei Liu, Department of Interventional Treatment, 980 (Bethune International Peace) Hospital of PLA Joint Logistics Support Forces, Shijiazhuang 050051, Hebei Province, China
Shu-Ya Jia, Department of Rehabilitation, Shijiazhuang People’s Hospital, Shijiazhuang 050000, Hebei Province, China
Author contributions: Song XJ and Zhang K proposed concepts for this study; Jia SY and Zhang K collected data; Song XJ, Zhang K, and Liu JL contributed to formal analysis; Zhang K and Liu JL contributed to the survey; Song XJ, Zhang K, and Jia SY contributed to this method; Song XJ and Liu JL supervised the study; Zhang K validated this study; Song XJ and Jia SY contributed to the visualization of research; Song XJ and Zhang K initially drafted this manuscript; Song XJ, Liu JL, Jia SY, and Zhang K reviewed and edited the manuscript.
Supported by the Hebei Medical Science Project Research Program Project, No. 20201411.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Shijiazhuang People’s Hospital (approval No. DX-2021-0021).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent.
Conflict-of-interest statement: We declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Zhang, MD, Attending Doctor, Department of Medical Oncology, Shijiazhuang People’s Hospital, No. 1 Fangbei Road, Chang'an District, Shijiazhuang 050000, Hebei Province, China. zkai202207@163.com
Received: May 6, 2023
Peer-review started: May 6, 2023
First decision: May 19, 2023
Revised: May 22, 2023
Accepted: May 26, 2023
Article in press: May 26, 2023
Published online: June 26, 2023
ARTICLE HIGHLIGHTS
Research background

The background of this study is the high prevalence of upper gastrointestinal bleeding in patients with cirrhotic portal hypertension. This can lead to significant morbidity and mortality, making early detection and prevention crucial. Multi-slice spiral computed tomography (CT) perfusion imaging is a non-invasive diagnostic tool that can provide detailed information on blood flow and vessel characteristics in the liver and portal vein. However, its predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension has not been fully explored. The present status of the study is to investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension. The study included 62 patients with cirrhotic portal hypertension and 28 healthy individuals, and various parameters were compared between the groups. Statistical analysis was used to identify factors associated with upper gastrointestinal bleeding, and a graph was created to compare the predictive value of different factors for bleeding. The significance of this study lies in its potential to improve the early detection and prevention of upper gastrointestinal bleeding in patients with cirrhotic portal hypertension. If multi-slice spiral CT perfusion imaging can accurately predict the risk of bleeding, clinicians can intervene earlier and prevent serious complications. Additionally, this study provides valuable information on the predictive value of specific parameters such as gastric coronary vein diameter (GCVD), number of blood vessels, and blood vessel area, which may guide future research and clinical practice. Ultimately, this study contributes to the ongoing effort to improve the management and outcomes of patients with cirrhotic portal hypertension.

Research motivation

The motivation for this research is the high prevalence of upper gastrointestinal bleeding in patients with cirrhotic portal hypertension, which can lead to significant morbidity and mortality. Early detection and prevention are crucial for improving patient outcomes, but current diagnostic tools have limitations. Multi-slice spiral CT perfusion imaging is a non-invasive diagnostic tool that offers detailed information on blood flow and vessel characteristics in the liver and portal vein. However, its predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension has not been fully explored. Therefore, this study aims to investigate the predictive accuracy of multi-slice spiral CT perfusion imaging and identify specific parameters that may have high predictive values. The results of this study could improve early detection and prevention of upper gastrointestinal bleeding in patients with cirrhotic portal hypertension, ultimately leading to better patient outcomes and quality of life.

Research objectives

To investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension and to compare various parameters such as liver blood flow, vein size, number of blood vessels, and blood vessel area between patients with bleeding and those without. The study aimed to identify factors associated with upper gastrointestinal bleeding in this patient population and create a graph comparing the predictive value of different factors for bleeding. The researchers also aimed to determine which parameter had the best predictive power for upper gastrointestinal bleeding in these patients. Overall, the study sought to evaluate the potential of multi-slice spiral CT perfusion imaging for predicting upper gastrointestinal bleeding in cirrhotic patients with portal hypertension.

Research methods

The research methods of this study involved a retrospective analysis of 62 patients with cirrhotic portal hypertension and 28 healthy individuals who served as controls. The disease group was further divided into two subgroups: Group A (n = 27, bleeding) and group B (n = 35, no bleeding). All participants underwent multi-slice spiral CT perfusion imaging at the hospital. The researchers compared various parameters such as liver blood flow, vein size, number of blood vessels, and blood vessel area between the two groups using statistical analysis. They calculated the OR to determine the strength of the association between these parameters and upper gastrointestinal bleeding. They also created a graph to compare the predictive value of different factors for bleeding. The research methods used in this study allowed the researchers to identify factors associated with bleeding and evaluate the potential of multi-slice spiral CT perfusion imaging for predicting upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension.

Research results

The research results showed that multi-slice spiral CT perfusion imaging had a significant predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension. The researchers found that the vascular area, number of vascular cross-sections, and GCVD had high predictive values for bleeding, with the vascular area having the best predictive power. They also identified several factors associated with upper gastrointestinal bleeding, including portal vein levels, hepatic artery perfusion index levels, portal vein diameter, splenic vein diameter, and the number and area of blood vessels. The statistical analysis revealed a strong link between GCVD, number of blood vessels, blood vessel area, and upper gastrointestinal bleeding. Overall, the study suggests that multi-slice spiral CT perfusion imaging can help predict upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension, and blood vessel area may be the strongest predictor among the evaluated parameters.

Research conclusions

The research conclusions of this study suggest that multi-slice spiral CT perfusion imaging can predict upper gastrointestinal bleeding well in patients with cirrhosis and portal hypertension. The study found that the vascular area, number of vascular cross-sections, and GCVD had high predictive values for bleeding, with the vascular area having the best predictive power. The researchers also identified several factors associated with upper gastrointestinal bleeding in this patient population. Overall, the study highlights the potential of multi-slice spiral CT perfusion imaging as a useful tool for predicting upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension. These findings may inform clinical decision-making and improve patient outcomes in this population.

Research perspectives

That future research can build upon these findings to further validate the use of multi-slice spiral CT perfusion imaging for predicting upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension. Future studies can explore the optimal cutoff values and diagnostic performance of different parameters identified in this study. Additionally, studies can investigate the potential of other imaging modalities or biomarkers for predicting upper gastrointestinal bleeding in this patient population. These efforts may further improve the management and outcomes of patients with cirrhosis and portal hypertension who are at risk of upper gastrointestinal bleeding.