Abstract: Objective To investigate the application value of shear wave elastography (SWE) and venous hemodynamic parameters in predicting the risk of esophageal variceal bleeding (EVB) in patients with Hepatitis B virus (HBV) cirrhosis. Methods A total of 126 patients with HBV cirrhosis admitted to our hospital from July 2020 to July 2023 were selected as the subjects of this study. Multifactorial regression analysis was employed to identify the risk factors for the occurrence of EVB in patients with HBV cirrhosis, and the predictive value of SWE and venous hemodynamic parameters was assessed using the receiver operating characteristic (ROC) curve. Results Univariate analysis indicated that the proportions of severe varices (61.29)% and the values of MCT (6.50±1.35) s, PET (15.18±2.21) s, LSM (16.54±5.55) kPa, and SSM (32.73±8.70) kPa in the bleeding group were significantly higher than that in the non-bleeding group (severe varices proportion 41.05)%, MCT (4.37±1.46) s, PET (12.53±2.95) s, LSM (13.14±4.95) kPa, SSM (25.14±8.59) kPa, while PLT levels (75.20±21.37) × 10⁹/L were lower than that in the non-bleeding group (102.45±26.21) × 10⁹/L (P<0.05). Multifactorial regression analysis revealed that the degree of varices, PLT, MCT, PET, LSM, and SSM were independent risk factors for EVB in patients with HBV-related cirrhosis (P<0.05). ROC curve analysis demonstrated that the combination of MCT, PET, LSM, and SSM parameters had an AUC of 0.957, with a sensitivity of 90.3% and a specificity of 92.6%. Conclusion The measurements of MCT, PET, LSM, and SSM are closely related to the risk of EVB in HBV patients with cirrhosis and can serve as effective predictive assessment indicators.

Key words: Shear wave elastography, Venous hemodynamic parameters, Hepatitis B cirrhosis, Esophageal variceal bleeding