Evaluation of esophageal varices in patients with chronic hepatitis B by real-time tissue elastography

Abstract

Abstract: Objective To evaluate the effectiveness of real-time elastography (RTE) in the diagnosis of esophageal varices (EVs) in patients with chronic hepatitis B. Methods We conducted a retrospective analysis of the clinical data, abdominal ultrasound, RTE and upper gastrointestinal endoscopy (EDG) results of 127 patients with chronic hepatitis B. The relationship between LF index and different grades of EVs was investigated. The AUROC was used to compare the diagnostic performance of various non-invasive markers for identifying patients with EVs and those at high-risk EVs. Results Among the 127 patients, EDG revealed EVs in 55 (43.3 %). Mild EVs were observed in 33 (26.0 %), moderate EVs in 11 (8.7 %), and severe EVs in 11 (8.7 %). Patients with EVs had lower PLT counts and higher levels of γ globulin, APRI, FIB-4, and LF index (P<0.001). A significant positive correlation was found between the LF index and the grade of EVs (P<0.001, r=0.802). The AUROC values for PLT, γ globulin, APRI, FIB-4, and LF index in diagnosing EVs were 0.296, 0.770, 0.797, 0.801 and 0.891, respectively. The optimal cut-off value for LF index was determined as 2.71, with corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic accuracy of 92.7%, 70.8%, 76.4%, 90.7%, 3.2, 0.1 and 81.8%, respectively. For the diagnosis of high-risk EVs, the AUROC values of PLT, gamma globulin, APRI, FIB-4, and LF index were 0.262, 0.858, 0.862, 0.897 and 0.935, respectively. The optimal cut-off value of LF index was 3.28, with corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and diagnostic accuracy of 86.6%, 90.5%, 90.3%, 87.1%, 9.1, 0.1, and 88.6%, respectively. Conclusion Real-time liver tissue elastography’s LF index displays strong diagnostic efficacy in detecting EVs in patients with chronic hepatitis B.

Key words: Real-time tissue elastography, Liver fibrosis index, Chronic hepatitis B, Esophageal varices

LIU Yun, XU Yun, HAN Liang, QIAN Yi, TAN Bi-bo. Evaluation of esophageal varices in patients with chronic hepatitis B by real-time tissue elastography[J]. Chinese Hepatolgy, 2024, 29(4): 423-428.

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