当前位置： SCI文献检索 > WORLD JOURNAL OF GASTROENTEROLOGY期刊下所有文献 > Value of transient elastography for the prediction of variceal bleeding.

Value of transient elastography for the prediction of variceal bleeding.

Abstract：

AIM:To determine if liver stiffness (LS) measurements by means of transient elastography (TE) correlate with the presence of significant esophageal varices (EV) and if they can predict the occurrence of variceal bleeding. METHODS:We studied 1000 cases of liver cirrhosis divided into 2 groups: patients without EV or with grade 1 varices (647 cases) and patients with significant varices (grade 2 and 3 EV) (353 cases). We divided the group of 540 cases with EV into another 2 subgroups: without variceal hemorrhage (375 patients) and patients with a history of variceal bleeding (165 cases). We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve. RESULTS:The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV (26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa, P < 0.0001). Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV, with 83% sensitivity (95% CI: 79.73%-85.93%) and 62% specificity (95% CI: 57.15%-66.81%), with 76.2% positive predictive value (PPV) (95% CI: 72.72%-79.43%) and 71.3% negative predictive value (NPV) (95% CI: 66.37%-76.05%) (AUROC 0.7807, P < 0.0001). The mean LS values in the group with a history of variceal bleeding (165 patients) was statistically significantly higher than in the group with no bleeding history (375 patients): 51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa, P < 0.0001). For a cut-off value of 50.7 kPa, LS had 53.33% sensitivity (95% CI: 45.42%-61.13%) and 82.67% specificity (95% CI: 78.45%-86.36%), with 82.71% PPV (95% CI: 78.5%-86.4%) and 53.66% NPV (95% CI: 45.72%-61.47%) (AUROC 0.7300, P < 0.0001) for the prediction of esophageal bleeding. CONCLUSION:LS measurement by means of TE is a reliable noninvasive method for the detection of EV and for the prediction of variceal bleeding.

journal_name

World J Gastroenterol

journal_title

World journal of gastroenterology

authors

Sporea I,Raţiu I,Sirli R,Popescu A,Bota S

doi

10.3748/wjg.v17.i17.2206

subject

Has Abstract

pub_date

2011-05-07 00:00:00

pages

2206-10

issue

eissn

1007-9327

issn

2219-2840

journal_volume

pub_type

杂志文章

在线工具

Value of transient elastography for the prediction of variceal bleeding.