Advances in CT Functional Imaging and Artificial Intelligence for Assessing Esophageal Varices in Cirrhosis

Esophageal varices (EV), which result from portal hypertension associated with cirrhosis, along with the consequent upper gastrointestinal bleeding, represent one of the most prevalent complications. Endoscopy is regarded as the "gold standard" for diagnosing varices; however, its invasive nature, coupled with poor patient compliance and the inconvenience of short-term follow-up, restricts its use in patients at low risk of bleeding. Consequently, there is a pressing need to identify a noninvasive imaging method that can accurately diagnose EV, evaluate their severity, and predict the risk of potential bleeding. In recent years, research focusing on the application of computed tomography (CT) functional imaging and novel artificial intelligence techniques in the context of EV has gained significant attention. The integration of these approaches may offer a new strategy for the effective diagnosis of portal hypertension and esophageal varices. This article aims to review the current research status and advancements in the use of CT for diagnosing EV, with the goal of assisting clinical diagnosis and treatment.