Original Article
The differences in clinical profiles and imaging features between liver cirrhosis combined with gastroesophageal varices type 2 and isolated gastric varices type 1
Si Keke, Xiang Hongyu, Wang Zehui, Song Yuhu, Li Xin
Published 2022-09-20
Cite as Chin J Dig Endosc, 2022, 39(9): 725-730. DOI: 10.3760/cma.j.cn321463-20211018-00502
Abstract
ObjectiveTo investigate the differences in clinical features and imaging findings of cirrhotic patients with fundic varices between gastroesophageal varices type 2 (GOV2) and isolated fundic varices type 1 (IGV1).
MethodsClinical and imaging data of cirrhotic patients with fundic varices treated in Union Hospital, Tonji Medical Colloge, of Huazhong University of Science and Technology from October 2013 to March 2021 were retrospectively analyzed.
ResultsA total of 210 patients were enrolled, including 139 patients of GOV2 (GOV2 group) and 71 patients of IGV1 (IGV1 group). Blood routine examination results showed that the median value of hemoglobin in GOV2 group was lower than that in IGV1 group(91.00 g/L VS 112.00 g/L, P<0.05). The incidence of portal hypertensive gastropathy (PHG) in GOV2 group was higher than that in IGV1 group [20.14% (28/139) VS 5.63% (4/71), P<0.05]. The incidence of peptic ulcer was lower in GOV2 group than that in IGV1 group [12.23% (17/139) VS 38.03% (27/71), P<0.05]. The median diameter of portal veins in GOV2 group was larger than that in IGV1 group (15.09 mm VS 12.85 mm, P<0.05), and the volume of gastric fundus varices in GOV2 group was smaller than that in IGV1 group (2.14 mL VS 10.00 mL, P<0.05). The proportion of afferent veins in left gastric vein in GOV2 group was higher than that in IGV1 group [98.43% (125/127) VS 77.78% (42/54), P<0.05], and the median diameter of left gastric vein in GOV2 group was larger than that in IGV1 group (5.58 mm VS 4.53 mm, P<0.05). The efferent vessels mainly included gastrorenal shunt and splenorenal shunt. The incidences of gastrorenal shunt [27.56% (35/127) VS 66.67% (36/54)] and splenirenal shunt [12.60% (16/127) VS 25.93% (14/54)] in GOV2 group were lower than those in IGV1 group ( both P<0.05). The incidences of venae parumbilicales vein [38.58% (49/127) VS 12.96% (7/54)] and retroperitoneal collateral shunt [30.71% (39/127) VS 11.11% (6/54)] in GOV2 group were higher than those in IGV1 group (both P<0.05).
ConclusionThere is significant heterogeneity in clinical features and imaging findings between cirrhotic patients complicated with GOV2 and IGV1. Recognizing and understanding the differences between the two types of patients is beneficial to taking appropriate clinical measures and improving patient prognosis.
Key words:
Liver cirrhosis; Gastric fundic varices; Gastrorenal shunt; Portal hypertensive gastropathy
Contributor Information
Si Keke
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Hubei Key Laboratory of Molecular Imaging,Wuhan 430030,China
Xiang Hongyu
Depertment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Wang Zehui
Depertment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Song Yuhu
Depertment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Li Xin
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Hubei Key Laboratory of Molecular Imaging,Wuhan 430030,China
