Evaluation of the combined detection of liver ultrasound blood flow parameters and liver-spleen stiffness in predicting esophageal variceal bleeding in hepatitis B cirrhosis patients

Abstract

Abstract: Objective To investigate the predictive value of liver ultrasound blood flow parameters combined with liver-spleen stiffness detection in predicting esophageal variceal bleeding in patients with hepatitis B cirrhosis. Methods From August 2021 to March 2024, 100 patients with hepatitis B cirrhosis treated at the Second People's Hospital of Lianyungang were selected for this study. Based on whether they experienced esophageal variceal bleeding during the follow-up period, the patients were divided into a bleeding group (34 cases) and a non-bleeding group (66 cases). All patients underwent Doppler ultrasound, contrast-enhanced ultrasound, and two-dimensional shear wave elastography (2D-SWE) for liver and spleen stiffness measurement. Parameters such as portal vein velocity (PVV), portal vein diameter (PVD), hepatic vein arrival time (HVAT), portal vein congestion index (PV-CI), and liver stiffness values were recorded. Results The bleeding group had lower PVV and HVAT but higher PVD, PV-CI, and liver stiffness values than the non-bleeding group (P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivities of liver stiffness value, PVV, PVD, PV-CI, and HVAT in predicting esophageal variceal bleeding were 44.1%, 64.7%, 76.5%, 52.9%, and 94.1%, respectively, and their specificities were 83.3%, 84.8%, 81.8%, 92.4%, and 86.4%, respectively. The area under the curve (AUC) values were 0.662, 0.810, 0.842, 0.800, and 0.953, respectively. When these parameters were combined, the sensitivity and specificity reached 95.5% and 94.1%, respectively, with an AUC value of 0.982. Conclusion The combined assessment of liver ultrasound blood flow parameters and liver-spleen stiffness measurement can effectively predict the risk of esophageal variceal bleeding in patients with hepatitis B-related cirrhosis, demonstrating significant clinical value. Early identification of high-risk patients allows for timely preventive interventions, reducing the risk of bleeding and improving patient outcomes.

Key words: Liver ultrasound blood flow parameters, Liver-spleen stiffness, Hepatitis B cirrhosis, Esophageal varices, Bleeding prediction

WANG Xian, LI Liang, WU Xin-yong, WANG Si-si. Evaluation of the combined detection of liver ultrasound blood flow parameters and liver-spleen stiffness in predicting esophageal variceal bleeding in hepatitis B cirrhosis patients[J]. Chinese Hepatolgy, 2025, 30(2): 197-200.

References

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