الفهرس 
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Abstract
CT and CT portography have become the tools of
investigation of the liver and can depict any problems regards
the varices by drawing the course of these varices which is
very important to avoid bleeding which could be life
threatening , also in major operations such as liver
transplantation .
CT by its various imaging techniques including 3D
imaging , MIP, MPR , VR is considered now gold standard
technique for imaging of the portal vein and its portosystemic
collaterals , even MRI or conventional angiographic
portography can not provide extra information .
CT could now replace many modalities such as
conventional angiographic portography or even the upper GI
endoscopy in variceal screening as it is safe , noninvasive ,
reliable and widely available .
In this study we have assessed 20 cases in
approximately 6 months at the Ain Shams university
hospitals , all patients were subjected to full history sheeting ,
Summary
full clinical examination , MDCT portography and to the
upper GI endoscopy .
It was found that 18 cases of 20 cases (90%) have
hepatic causes of portal hypertension while 1 case due to
periportal fibrosis and another due to budd-chiari syndrome .
Regarding portal vein it was found that the portal vein
dilation present in 9 cases about 45 % of the cases and there
is significant correlation between portal vein diameter and
number of collaterals , as the number of collaterals increases
when the diameter of the portal vein decreases
Regarding the detected portosystemic collaterals it
was found that the peri-spleenic collaterals are the most
common type 70% (14 cases), while the esophageal varices
represent 40% (8 cases) and the gastric varices 35 % (7
cases) .
The cases that were positive for gastro-esophageal
collaterals in CT were also positive for gastro-esophageal
collaterals in the upper GI endoscopy , which is meaning that
the CT is very good excluded modality with 100%
sensitivity.
Summary
While the CT was upgrading – over reader for 3 cases
from 20 cases (15%) in esophageal varices from the low risk
zone to high risk zone in comparison with the upper GI
endoscopy , which is meaning that tha CT has 82 %
specificity in grading the esophageal collaterals , also in
gastric varices was found that the CT is upgrading in 2 cases
from 20 (10%) cases from the low risk to the high risk zone
in comparison with the upper GI endoscopy with 89 %
specificity