瞬态弹性成像识别乙型肝炎病毒相关性肝硬化患者食管静脉

StephenW

Ultrasound Q. 2018 Jul 17. doi: 10.1097/RUQ.0000000000000373. [Epub ahead of print]
Transient Elastography Identifies the Risk of Esophageal Varices and Bleeding in Patients With Hepatitis B Virus-Related Liver Cirrhosis.
Zhu Q, Wang W1, Zhao J1, Al-Asbahi AAM1, Huang Y1, Du F1, Zhou J1, Song Y1, Xu K1, Ye J1, Yang L1.
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Abstract

This study aimed to analyze the diagnostic accuracy of liver stiffness for predicting esophageal variceal grading and the risk of esophageal variceal bleeding (EVB) in cases of cirrhosis. Hematological and biochemical parameters were measured and transient elastography was performed in 88 patients with hepatitis B-related cirrhosis undergoing endoscopy for esophageal varices. Esophageal varices grade was highly correlated with liver stiffness measurement (LSM) and the liver stiffness spleen diameter-to-platelet score in cirrhosis. Compared with those from endoscopy, the LSM and the liver stiffness spleen diameter-to-platelet score for the absence of esophageal varices were as follows: area under the receiver operating characteristic curve (AUROC), 0.894/0.926; sensitivity, 0.836/0.818; and specificity, 0.875/1.000, respectively. The AUROC and the sensitivity and specificity of LSM and the liver stiffness spleen diameter-to-platelet score for predicting grade III esophageal varices were 0.954 and 0.901, respectively. The AUROCs of LSM and the liver stiffness spleen diameter-to-platelet score for discriminating grades II and III from grade I or the absence of esophageal varices were 0.958 and 0.941, respectively. We also found that EVB was closely associated with LSM and spleen diameter. The AUROC, sensitivity, and specificity were 0.855/0.819, 0.857/0.875, and 0.747/0.780, respectively. Meanwhile, LSM and spleen diameter were 2 independent factors for predicting EVB. These data suggest that LSM and the liver stiffness spleen diameter-to-platelet score could accurately rule out cirrhosis without esophageal varices and differentiate high- and low-risk patients. Furthermore, LSM and spleen diameter had excellent abilities to predict EVB.

PMID:
    30020268
DOI:
    10.1097/RUQ.0000000000000373

StephenW

超声Q. 2018年7月17日doi：10.1097 / RUQ.0000000000000373。 [提前打印]
瞬态弹性成像识别乙型肝炎病毒相关性肝硬化患者食管静脉曲张和出血的风险。
Zhu Q，Wang W1，​​Zhao J1，Al-Asbahi AAM1，Huang Y1，Du F1，Zhou J1，Song Y1，Xu K1，Ye J1，Yang L1。
作者信息
抽象

本研究旨在分析肝硬度的诊断准确性，以预测食管静脉曲张分级和肝硬化患者食管静脉曲张出血（EVB）的风险。测量血液学和生化参数，并对88例接受内镜检查的食管静脉曲张的乙肝相关性肝硬化患者进行瞬时弹性成像。食管静脉曲张等级与肝硬度测量（LSM）和肝硬化脾脏直径 - 血小板评分高度相关。与内镜检查相比，食管静脉曲张缺失的LSM和肝硬度脾脏直径 - 血小板评分如下：受试者工作特征曲线下面积（AUROC），0.894 / 0.926;灵敏度，0.836 / 0.818;和特异性，分别为0.875 / 1.000。对于预测III级食管静脉曲张，AUROC和LSM的灵敏度和特异性以及肝硬度脾脏直径 - 血小板评分分别为0.954和0.901。 LSM的AUROCs和肝硬度脾脏直径 - 血小板评分，用于区分I级II级和III级或没有食管静脉曲张，分别为0.958和0.941。我们还发现EVB与LSM和脾脏直径密切相关。 AUROC，灵敏度和特异性分别为0.855 / 0.819,0.857 / 0.875和0.747 / 0.780。同时，LSM和脾脏直径是预测EVB的2个独立因素。这些数据表明，LSM和肝硬度脾脏直径 - 血小板评分可以准确地排除没有食管静脉曲张的肝硬化，并区分高风险和低风险患者。此外，LSM和脾脏直径具有很好的预测EVB的能力。

结论：
    30020268
DOI：
    10.1097 / RUQ.0000000000000373