Evaluation of gastroesophageal varices with three-dimensional visualization technology / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To observe the prognostic value of Medical Image Three-dimensional (3D) Visualization System (MI-3DVS) in evaluation of the distribution and blood supply of gastroesophageal varices (EGV).</p><p><b>METHODS</b>3D reconstruction was played by MI-3DVS and CT-maximum intensity projection (CT-MIP) respectively on multi slice computed tomography (MSCT) date of 51 patients with EGV from February 2010 to October 2012. The demonstration rate of collateral vessels in spleen and stomach area, EGV typing and the blood supply between the two methods were observed and compared.</p><p><b>RESULTS</b>The demonstration rates of LGV, gastro-renal shunt, splenorenal shunt and PGV showed a high coincidence between the MI-3DVS and CT-MIP (κ = 0.882-1.000), and moderate agreements in SGV and paraesophageal varices (κ = 0.646 and 0.757). The outcome of EGV classification (MI-3DVS vs. CT-MIP) were typeIfor 31 vs. 28 cases, type II for 6 vs. 4 cases, type III for 4 vs. 4 cases and type IV for 6 vs.10 cases, the 2 methods show high agreements (weighted Kappa value of 0.848 and P < 0.01).Significant differences were found in the blood supply distribution among the four types of EGV (χ(2) = 36.647, P < 0.01); and the blood supply of the EGV tended to be a strong correlation with EGV classification (C = 0.769 and 0.744, P = 0.000). There were 12 patients with gastro-renal shunt and 5 patients with Spleno-renal shunt.</p><p><b>CONCLUSIONS</b>MI-3DVS can explicitly determine the location, blood vessel diameter and blood supply of the EGV, which is helpful for us to grab the formation of collateral circulation completely. The 3D reconstruction of MI-3DVS has guidance and current significance in optimizing therapeutic schedule or preoperative planning.</p>