To investigate the imaging features of preoperative multislice CT angiography (MSCTA), neutrophil to lymphocyte ratio (NLR), Glasgow-Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score changes and their prognostic significance in patients with esophageal and gastric variceal bleeding (EVB) due to cirrhosis.

A total of 100 liver cirrhosis patients with EVB admitted to Baoji High-tech Hospital from January 2022 to August 2024 were included as study objects, all patients received treatments such as endoscopic esophageal variceal ligation, ligation combined with sclerotherapy injection or interventional embolization, and completed MSCTA examination before the operation. The two groups of patients were followed up for 6 months, according to the prognosis and survival status of the patients, they were divided into the survival group (n=88) and the death group (n=12). Preoperative MSCTA imaging features [maximum transverse diameters of left gastric vein (LGV), main portal vein (MPV), superior mesenteric vein (SMV) and splenic vein (SPV)], NLR, GBS, PRS and AIMS65 scores were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between imaging features, NLR, GBS, PRS, AIMS65 scores and prognosis of EVB patients with cirrhosis. Receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of MSCTA imaging features, NLR, GBS, PRS and AIMS65 scores in EVB patients with cirrhosis.

The maximum transverse diameters of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 scores in the death group were significantly higher than those in the survival group (P<0.05). LGV, MPV, SMV, SPV, NLR, GBS, PRS, AIMS65 were positively correlated with the prognosis of EVB patients with cirrhosis (P<0.05); ROC curve analysis results showed that the area under the curve (AUC) of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 were 0.837, 0.675, 0.695, 0.861, 0.694, 0.857, 0.974 and 0.972. The sensitivity was 0.750, 0.500, 0.583, 0.667, 0.667, 0.917, 0.833, 0.917, and the specificity was 0.989, 0.841, 0.773, 0.955, 0.773, 0.682, 0.989, 0.989 (P<0.05).

Preoperative MSCTA imaging features, NLR and GBS, PRS, AIMS65 scoring systems can effectively predict the prognosis of EVB patients with cirrhosis, the comprehensive application of these indicators can improve the accuracy of prognosis assessment, optimize treatment plan, and improve the survival rate of patients.