Duplex Ultrasound Evaluation of Portal Vein Congestion Index as a Predictor of Esophageal Varices: A Cross- sectional Study

Abstract

Background: The assessment of esophageal varices is critical in managing patients with portal hypertension, particularly those with liver cirrhosis. Duplex ultrasound offers a non-invasive method to evaluate portal hemodynamics, including the portal vein congestion index (PVCI), which is defined as the ratio of the cross-sectional area of the portal vein to the portal vein velocity.

Objectives: The aim of the study was to evaluate the duplex ultrasound evaluation of portal vein congestion index as a predictor of esophageal varices.

Methods: This cross-sectional study was conducted in the Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka, from July 2021 to June 2023. Duplex study was done on 58 patients known case of cirrhosis of liver patients who attended the outpatient department or indoor of department of Dhaka Medical College Hospital, Dhaka. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24).

Results: According to age, the majority of the study participants (17, 29.3%) were between the ages of 40 and 49, with 77.60% being male. The congestion index demonstrated a significant correlation with the presence of EV on EGD (p<0.05). The sensitivity of congestion index was 94.87%. The congestion index had the highest specifity at 84.21% and highest negative predictive value at 88.89%. Positive predicative value was also highest for the congestion index at 92.50% and accuracy was highest at 91.38%.

Conclusion: PVCI is a reliable, non-invasive predictor of esophageal varices and could be used as a screening tool to reduce the need for routine endoscopic examinations.

J Com Med Col Teachers’ Asso Jan 2025; 29(1): 52-58