Evaluation of spleen stiffness by 2D shear wave elastography for ruling out high risk varices in patients with chronic advanced liver disease. A systematic review and meta-analysis.
Eur J Radiol
; 175: 111475, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38643527
ABSTRACT
OBJECTIVES:
To systematically review the accuracy of spleen stiffness measurement (SSM) by 2D- Shear Wave Elastography (2D-SWE) in predicting high risk for bleeding varices (HRV) in cirrhotic patients.METHODS:
PubMed, Embase, Web of Science, Medline, Cochrane, and Google Scholar databases were searched up to 31/05/2023 for all human studies using 2D-SWE to estimate SSM and endoscopy to detect HRV. Meta-analysis was performed using a generalized linear mixed model. Publication bias was evaluated using the funnel plot asymmetry test. The Area Under the Summarized Receiver Operating Characteristic curve (AUSROC) was estimated using the "mada" package.RESULTS:
A total of 13 studies and 1970 patients were included. Of them, 27.8 % had HRV. The pooled sensitivity and polled specificity of SSM in detecting HRV were 90 % (95 %CI87-92 %) and 68 % (95 %CI58-77 %), respectively, with an AUSROC at 0.86 (95 %CI0.82-0.90). The median cutoff value of SSM in detecting HRV was 34.2 kPa. In studies including exclusively HBV cirrhotic patients, SSM's polled sensitivity and specificity in predicting HRV was 88 % (95 %CI82-92 %) and 73 % (95 %CI68-78 %), respectively. The AUSROC was 0.84 (95 %CI0.81-0.87). The number of repeated measurements per patient (<5 or ≥ 5) did not affect the method's capability. Using Aixplorer to evaluate SSM had a higher sensitivity in ruling out HRV than other 2D-SWE devices.CONCLUSIONS:
Our meta-analysis supports that SSM by 2D-SWE has a good diagnostic performance for ruling out HRV in cirrhosis.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Baço
/
Técnicas de Imagem por Elasticidade
Limite:
Humans
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2024
Tipo de documento:
Article