<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction.</bold> Current guidelines recommend that all patients with cirrhosis undergo upper gastrointestinal endoscopy (UGE) screening for esophageal varices (EV). Unfortunately, UGE has a lot of disadvantages, consequently various non-invasive methods of diagnosing EV have been proposed. We evaluated if spleen stiffness (SS) measured by Acoustic Radiation Force Impulse (ARFI) is a viable technique in diagnosing EV.<bold>Methods.</bold> We recruited 178 patients with cirrhosis caused by Hepatitis B and C who underwent biochemical tests, abdominal ultrasound, UGE, LS and SS measurements using ARFI elastography. Based on the endoscopic results the patients were divided in 3 groups: without EV, with small EV (&lt;5 mm) and with large EV (>5 mm).<bold>Results.</bold> ARFI SS was the only non-invasive parameter associated with the presence of EV (2.7±0.30 vs. 3.4±0.52, p&lt;0.001) and large EV (2.91±0.36 vs. 3.86±0.37, p=0.001) after multivariate logistic regression (p&lt;0.001). ARFI SS for predicting EV showed an AUROC of 0.872 (CI 95%: 0.799–0.944), for a cut-off value of 2.89 m/s: Sensitivity (Se) 91.4% (CI 95%: 81–97%), Specificity (Sp) 67.7% (CI 95%: 51–85%). ARFI SS for diagnosing large EV (>5mm) had better results with an AUROC 0.969 (CI 95%:0.935–0.99), and for a cut-off of 3.30 m/s: Se 96.4% (CI 95%: 82–99.9%), Sp 88.5% (CI 95%: 78–95%).<bold>Conclusions.</bold> SS measured using ARFI is a good method of detecting EV and is an excellent method of diagnosing large EV in patients with virus-related cirrhosis.</abstract>

Introduction. Current guidelines recommend that all patients with cirrhosis undergo upper gastrointestinal endoscopy (UGE) screening for esophageal varices (EV). Unfortunately, UGE has a lot of disadvantages, consequently various non-invasive methods of diagnosing EV have been proposed. We evaluated if spleen stiffness (SS) measured by Acoustic Radiation Force Impulse (ARFI) is a viable technique in diagnosing EV.Methods. We recruited 178 patients with cirrhosis caused by Hepatitis B and C who underwent biochemical tests, abdominal ultrasound, UGE, LS and SS measurements using ARFI elastography. Based on the endoscopic results the patients were divided in 3 groups: without EV, with small EV (<5 mm) and with large EV (>5 mm).Results. ARFI SS was the only non-invasive parameter associated with the presence of EV (2.7±0.30 vs. 3.4±0.52, p<0.001) and large EV (2.91±0.36 vs. 3.86±0.37, p=0.001) after multivariate logistic regression (p<0.001). ARFI SS for predicting EV showed an AUROC of 0.872 (CI 95%: 0.799–0.944), for a cut-off value of 2.89 m/s: Sensitivity (Se) 91.4% (CI 95%: 81–97%), Specificity (Sp) 67.7% (CI 95%: 51–85%). ARFI SS for diagnosing large EV (>5mm) had better results with an AUROC 0.969 (CI 95%:0.935–0.99), and for a cut-off of 3.30 m/s: Se 96.4% (CI 95%: 82–99.9%), Sp 88.5% (CI 95%: 78–95%).Conclusions. SS measured using ARFI is a good method of detecting EV and is an excellent method of diagnosing large EV in patients with virus-related cirrhosis.

The role of spleen stiffness using ARFI in predicting esophageal varices in patients with Hepatitis B and C virus-related cirrhosis

Carol Davila University of Medicine and Pharmacy

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction. Current guidelines recommend that all patients with cirrhosis undergo upper gastrointestinal endoscopy (UGE) screening for esophageal varices (EV). Unfortunately, UGE has a lot of disadvantages, consequently various non-invasive methods of diagnosing EV have been proposed. We evaluated if spleen stiffness (SS) measured by Acoustic Radiation Force Impulse (ARFI) is a viable technique in diagnosing EV.Methods. We recruited 178 patients with cirrhosis caused by Hepatitis B and C who underwent biochemical tests, abdominal ultrasound, UGE, LS and SS measurements using ARFI elastography. Based on the endoscopic results the patients were divided in 3 groups: without EV, with small EV (5 mm).Results. ARFI SS was the only non-invasive parameter associated with the presence of EV (2.7±0.30 vs. 3.4±0.52, p5mm) had better results with an AUROC 0.969 (CI 95%:0.935–0.99), and for a cut-off of 3.30 m/s: Se 96.4% (CI 95%: 82–99.9%), Sp 88.5% (CI 95%: 78–95%).Conclusions. SS measured using ARFI is a good method of detecting EV and is an excellent method of diagnosing large EV in patients with virus-related cirrhosis.

Introduction. Current guidelines recommend that all patients with cirrhosis undergo upper gastrointestinal endoscopy (UGE) screening for esophageal varices...

The role of spleen stiffness using ARFI in predicting esophageal varices in patients with Hepatitis B and C virus-related cirrhosis

Published Online: Dec 16, 2019

Page range: 334 - 340

Received: Jun 04, 2019

DOI: https://doi.org/10.2478/rjim-2019-0017

Keywords
acoustic radiation force impulse, cirrhosis, esophageal varices, spleen stiffness, liver stiffness

© 2019 Răzvan Peagu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The role of spleen stiffness using ARFI in predicting esophageal varices in patients with Hepatitis B and C virus-related cirrhosis

Published Online: Dec 16, 2019

Page range: 334 - 340

Received: Jun 04, 2019

DOI: https://doi.org/10.2478/rjim-2019-0017

Keywordsacoustic radiation force impulse, cirrhosis, esophageal varices, spleen stiffness, liver stiffness

© 2019 Răzvan Peagu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
acoustic radiation force impulse, cirrhosis, esophageal varices, spleen stiffness, liver stiffness