The gold standard method for the identification of the grades of the varices is upper gastrointestinal endoscopy. However, it is invasive and uncomfortable, and this can limit the frequency of examination.[7] Recent studies have been performed to identify predictive non-invasive factors for esophageal varices such as platelet Epigenetics Compound Library mouse count of 82 000/uL or less, PV diameter of 11.5 mm or more, and anteroposterior splenic measurement of 103 mm or more, but none of the

factors could visualize the varices, and how to grade the varices with these factors were not studied.[8-11] With the development of imaging technology, magnetic resonance (MR) portography has been described as being comparable to Erastin endoscopy for the detection of esophageal varices due to its short acquisition time, high signal-to-noise ratio and no radiation.[12-16] It can not only visualize the anatomical distributions of the varices, but also can analyze the inflowing vein of the varices (LGV) and its originating vein which play important roles in the formation and

development of the varices.[2, 17-19] Furthermore, cirrhotic patients often receive hepatocellular carcinoma surveillance with MR imaging which could be used as a “one-stop-shop” approach evaluating the varices at the same time without the need for a second study.[20] To our knowledge, there has been no report focusing on the utility of MR imaging to determine the association of the presence and endoscopic grades of the varices with the diameters of the inflowing vessel (LGV) and its originating vein (PV or SV). Therefore, the aim of this study was to determine whether the diameters of LGV and its originating veins are find more associated with the presence and endoscopic grades of esophageal varices for better understanding and to prevent massive hemorrhage of the upper alimentary tract. THE STUDY WAS approved by the institutional ethics review board of our university

hospital, and written informed consent was obtained from each participant before the study. Patients were enrolled into this study according to the following inclusion criteria: (i) PHT secondary to liver cirrhosis in patients with hepatitis B was confirmed by clinical data, laboratory examinations and imaging study according to the American Association for the Study of Liver Diseases practice guidelines 2007 – Chronic Hepatitis B;[21] and (ii) patients underwent 3-D contrast-enhanced MR portography and upper gastrointestinal endoscopy. The interval between the MR scan and endoscopy was less than 3 days. Patients were excluded from this study if they had a history of upper gastrointestinal bleeding and received any treatment to esophageal varices; or if they had PV or SV emboli, fistula of the hepatic artery–PV, hepatic carcinoma, splenectomy and other diseases which might affect the hemodynamics of the portal venous system.