Abstract: Objective The aim of this study was to explore the application of semi-quantitative scoring (SQS) based on ultrasonography in evaluating the severity of esophageal varices (EV) in patients with hepatitis B cirrhosis. Methods 124 patients with hepatitis B cirrhosis underwent gastroscopy in our hospital between June 2020 and January 2022. The routine liver ultrasonography and semi-quantitative scoring were conducted. Based on blood biochemical index and demographic data, the fibrosis index based on the four factors (FIB-4) and aspartate aminotransferase/platelet index (APRI) were calculated. The evaluation efficacy of each index for moderate to severe EV was assessed by receiver operating characteristic (ROC) curves. Results The gastroscopy showed that among the 124 patients with hepatitis B cirrhosis, there were 46 cases (37.1%) in stage G0, 30 cases (24.2%) in stage G1, 28 cases (22.6%) in stage G2 and 20 cases (16.1%) in stage G3 of EV, e.g. 48 cases (38.7%) with moderate to severe EV (G2-G3); the SQS, FIB-4 and APRI scores in patients at stages G2-G3 were (13.1±1.9), (5.7±1.1) and (1.7±0.3), significantly higher than [(11.8±1.5) , (4.2±0.7) and (1.1±0.2), P<0.05] in patient with stage G1 or [(10.8±1.7) , (2.7±0.5) and (0.7±0.2), respectively, P<0.05] in those with stage G0; the cut-off values of SQS, FIB-4 and APRI for assessing moderate to severe EV were 12.7, 5.0 and 1.4, respectively, and their sensitivity and specificity were 91.7% and 73.7%, 89.6% and 67.1%, and 87.5% and 72.4%, without significant differences as respect to the diagnostic performance among them (P>0.05). Conclusion As a non-invasive approach, the application of semi-quantitative scoring based on ultrasonography is practical in evaluating moderate to severe EV in patients with hepatitis B cirrhosis.

Key words: Liver cirrhosis, Esophageal varices, Digestive endoscope, Ultrasonography, Semi-quantitative scoring, Diagnosis