Liver and spleen stiffness in diagnosing esophageal varices and predicting high risk of esophageal and gastric varices bleeding / 中国医学影像技术

ABSTRACT

Objective To explore the value of liver and spleen stiffness in diagnosing esophageal and gastric varices (EGV) and predicting high risk of EGV bleeding in patients with hepatitis B virus (HBV)-related liver cirrhosis.Methods Totally 71 patients with HBV-related liver cirrhosis who had undergone endoscopy were prospectively recruited.Then acoustic radiation force imaging (ARFI) was performed.The severity of EGV was graded and ROCs were drawn on the liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) to detect the value of liver and spleen stiffness in diagnosing EGV and predicting the high risk of EGV bleeding.Results There were significant differences of LSWV and SSWV between patients with EGV and without EGV (all P＜0.001).Taking endoscopy results as golden standards,the areas under ROC curve of LSWV and SSWV were 0.877 and 0.910 (both P＜0.001) in diagnosing esophageal varices,and the optimal cut-off values were 2.01 m/s and 2.84 m/s (sensitivity 93.5％ and 76.1％,specificity 76.0％ and 92.0％),respectively.Areas under ROC curve of LSWV and SSWV in predicting the high risk of EGV bleeding were 0.882 and 0.914 (both P＜0.001),and the optimal cut-off values were 2.27 m/s and 2.94 m/s (sensitivity 77.1％ and 85.7％,specificity 83.3％ and 91.7％),respectively.Conclusion Liver and spleen stiffness are useful in diagnosing EGV and predicting the high risk of EGV bleeding in patients with HBV-related liver cirrhosis.