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Multimodal Ultrasound Model Based on the Left Gastric Vein in B-Viral Cirrhosis: Noninvasive Prediction of Esophageal Varices.
Xu, Xinzhi; Jin, Ying; Lin, Yuanqiang; Hu, Dongmei; Zhou, Yaoyao; Li, Dianqiu; Wang, Hui; Jin, Chunxiang.
Afiliação
  • Xu X; 1Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China; 2Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin, China; 3Department of Ultrasound, The Second Hospital of Jilin University, Changchun, Jilin, China.
Clin Transl Gastroenterol ; 11(11): e00262, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33259161
ABSTRACT

OBJECTIVES:

To establish and verify a simple noninvasive model based on the left gastric vein (LGV) to predict the grade of esophageal varices (EV) and high-risk EV (HEV), to facilitate clinical follow-up and timely treatment.

METHODS:

We enrolled 320 patients with B-viral cirrhosis. All patients underwent endoscopy, laboratory tests, liver and spleen stiffness (SS), and ultrasonography. HEV were analyzed using the χ test/t test and logistic regression in the univariate and multivariate analyses, respectively. EV grades were analyzed using the variance/rank-sum test and logistic regression. A prediction model was derived from the multivariate predictors.

RESULTS:

In the training set, multivariate analysis showed that the independent factors of different EV grades were SS, LGV diameter, and platelet count (PLT). We developed the LGV diameter-SS to PLT ratio index (LSPI) and LGV diameter/PLT models without SS. The area under the receiver operating characteristic curve of the LSPI for diagnosis of small EV, medium EV, large EV, and HEV was 0.897, 0.899, 0.853, and 0.954, respectively, and that of the LGV/PLT was 0.882, 0.890, 0.837, and 0.942, respectively. For the diagnosis of HEV, the negative predictive value was 94.07% when LSPI < 19.8 and the positive predictive value was 91.49% when LSPI > 23.0. The negative predictive value was 95.92% when LGV/PLT < 5.15, and the positive predictive value was 86.27% when LGV/PLT > 7.40. The predicted values showed similar accuracy in the validation set.

DISCUSSION:

Under appropriate conditions, the LSPI was an accurate method to detect the grade of EV and HEV. Alternatively, the LGV/PLT may also be useful in diagnosing the varices when condition limited.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Clin Transl Gastroenterol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Clin Transl Gastroenterol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China