Validation of the Baveno VI criteria to rule out high-risk varices using hepatic shear-wave elastography.
Eur J Gastroenterol Hepatol
; 35(5): 559-567, 2023 05 01.
Article
em En
| MEDLINE
| ID: mdl-36966754
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Liver stiffness measurement (LSM) by transient elastography has been validated to predict high-risk varices (HRV). We aimed to evaluate the accuracy of shear-wave elastography (SWE) and platelet count (Baveno VI criteria) to rule out HRV in patients with compensated advanced chronic liver disease (c-ACLD).METHODS:
This retrospective study analyzed data of patients with c-ACLD (transient elastographyâ ≥â 10â kPa) submitted to two-dimensional SWE (2D-SWE) (GE-LOGIQ-S8) and/or point SWE (p-SWE) (ElastPQ) who had a gastrointestinal endoscopy within 24â months. HRV definition was a large size and presence of red wale marks or sequelae from previous treatment. Optimal thresholds of SWE systems for HRV were identified. The proportion of spared gastrointestinal endoscopies and missing HRV considering a favorable SWE Baveno VI criteria were assessed.RESULTS:
Eighty patients [36% male, median ageâ =â 63 (interquartile range, 57-69) years] were included. The prevalence of HRV was 34% ( n â =â 27/80). The optimal thresholds to predict HRV were 10â kPa and 12â kPa for 2D-SWE and p-SWE, respectively. A favorable 2D-SWE Baveno VI criteria (LSMâ <â 10â kPa and platelets countâ >â 150â ×â 10 9 /mm 3 ) avoided 19% of gastrointestinal endoscopies without missing HRVs. A favorable p-SWE Baveno VI criteria (LSMâ <â 12â kPa and platelets countâ >â 150â ×â 10 9 /mm 3 ) spared 20% of gastrointestinal endoscopy without missing HRVs. Using a lower threshold of platelet count (<110â ×â 10 9 /mm 3 , expanded Baveno VI), 2D-SWE (<10â kPa) avoided 33% of gastrointestinal endoscopy with 8% of missing HRVs, while p-SWE (<12â kPa) avoided 36% of gastrointestinal endoscopy with 5% of missing HRVs.CONCLUSION:
LSM by p-SWE or 2D-SWE combined with platelet count (Baveno VI criteria) can spare a considerable number of gastrointestinal endoscopies missing a negligible proportion of HRV.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Varizes
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Varizes Esofágicas e Gástricas
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Técnicas de Imagem por Elasticidade
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Hepatopatias
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Gastroenterol Hepatol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2023
Tipo de documento:
Article