Abstract
INTRODUCTION: To compare serological and CT imaging parameters between the mild and severe portal hypertensive gastropathy (PHG) group, and find out the non-invasive predictive markers for PHG severity based on these differences. METHODS: Three hundred one patients were enrolled in our retrospective study. The PHG severity was assessed by esophagogastroduodenoscopy (EGD), and serological markers were measured within 48 h before EGD, and CT scans were performed within one week after EGD. Differences in age, gender, etiology, serological and CT imaging parameters, and arterial-phase gastric wall enhancement in CT scans were analyzed between the mild and severe PHG groups. RESULTS: No significant differences were observed in gender, age, etiology, serological markers, or MELD score between the two groups (all P > 0.05). However, spleen length, spleen volume, PLT/spleen length ratio, and PLT/spleen volume ratio differed significantly (P = 0.003, 0.011, 0.019, and 0.014, respectively). The optimal cutoff values for predicting PHG severity were 131.4 (AUC = 0.619), 613.29 (AUC = 0.596), 0.42 (AUC = 0.588), and 0.07 (AUC = 0.592), respectively. Patients with severe PHG demonstrated significantly greater arterial-phase gastric wall enhancement compared to mild PHG cases. CONCLUSION: Spleen length, spleen volume, and the platelet-to-spleen ratios presented predictive value for PHG severity, albeit with limited discriminative ability. Additionally, moderate-to-severe arterial phase gastric wall enhancement in CT scans may serve as a potential indicator of severe PHG.