Abstract: Objective The aim of this study was to investigate efficacy of ultrasound shear wave elastography (SWE) in predicting esophageal variceal bleeding (EVB) in patients with liver cirrhosis (LC). Methods 79 patients with LC were encountered in our hospital between May 2022 and February 2024, and all underwent gastroscopy to determine esophageal varices (EV). SWE was conducted to record Yang’s modulus in region of interest (ROI) as maximum value (Emax), minimum value (Emin) and mean value (Emean). The risk factors of EVB in patients with LC were explored by multivariate Logistic regression analysis, and predicting efficacy was analyzed by receiver operating characteristic (ROC) curve. Results Gastroscopy found mild EV in 12 cases, moderate in 32 cases and severe in 35 cases; by end of one-year follow-up, EVB occurred in 30 cases (38.0%) in our series; percentages of ascites and Child-Pugh class C in patients with EVB were 53.3% and 90.0%,both significantly higher than 10.2% and 18.4%(P<0.05), and serum ALB level and peripheral blood PLT count were (30.7±2.6)g/L and (65.9±13.2)×10⁹/L, both much lower than [(35.9±4.2)g/L and (94.2±11.8)×10⁹/L,respectively, P<0.05] in those without EVB; Emax, Emin and Emean in patients with EVB were (17.4±3.1)kPa, (11.3±2.1)kPa and (14.0±2.6)kPa,all much greater than [(12.7±2.6)kPa, (8.7±1.8)kPa and (11.2±2.2)kPa,respectively, P<0.05] in those without EVB; multivariate Logistic regression analysis showed that PLT counts((OR=1.458,95% CI:1.140-2.162), Emax(OR=1.415,95% CI:1.103-1.815),Emin(OR=1.318,95% CI:1.056-1.645) and Emean(OR=1.631,95%CI:1.232-2.158) were all the independent risk factors for EVB occurrence; ROC analysis demonstrated that the AUC was 0.900(95% CI:0.812-0.956), with sensitivity of 70.0% and specificity of 95.9%, when PLT count combined with SWE parameters was set in predicting EVB risk. Conclusion SWE parameters in combination with PLT counts is valuable in predicting EVB risk in patients with decompensated LC, which might help clinicians making appropriate measures early in clinical practice.

Key words: Liver cirrhosis, Esophageal variceal bleeding, Ultrasound shear wave elastography, Yang’s modulus, Prediction