We evaluated the diagnostic performance of radiologists for the detection of high-risk esophageal varices on regular follow-up liver multi-detector row CT (MDCT) examinations in patients treated with locoregional therapies for hepatocellular carcinoma (HCC). A total of 110 cirrhotic patients that had undergone liver MDCT at 4 weeks or sooner before an upper endoscopy were evaluated. Three abdominal radiologists independently interpreted the CT images with the shortest interval of endoscopy in order to detect the presence of high-risk (grade 2 or 3) esophageal varices. With endoscopic grading as the reference standard, the diagnostic performances (areas under the ROC curves) of the three radiologists were 0.977 +/- 0.018, 0.957 +/- 0.024, and 0.939 +/- 0.028, respectively. The mean sensitivity and specificity of the three radiologists were 91.9% and 92.2%, respectively. Our results showed excellent diagnostic performances of radiologists to detect high-risk esophageal varices on regular follow-up liver MDCT in patients treated with locoregional therapies for HCC.