超声联合剪切波弹性成像评估肝硬化门脉高压症患者并发高风险食管静脉曲张价值分析*

doi:10.3969/j.issn.1672-5069.2025.01.026

Abstract

Abstract: Objective The aim of this study was to investigate diagnostic performance of ultrasonography and shear wave elastography (SWE) in predicting high risk esophageal varices (HREV) in patients with liver cirrhosis (LC). Methods 92 patients with LC and cirrhotic portal hypertension were admitted to our hospital between January 2022 and April 2024, and all underwent ultrasonography for portal vein diameter (PVD), splenic vein diameter (SVD), portal vein maximum velocity (PVVmax) and splenic vein maximum velocity (SVVmax). Liver stiffness measurement (LSM) and splenic stiffness measurement (SSM) were measured by using SWE mode. Multivariate Logistic regression analysis was applied to reveal impacting factors, and receiver operating characteristic (ROC) curve was used to evaluate diagnostic efficacy. Results Endoscopy found HREV in 35 cases (38.0%) in 92 patients with cirrhotic portal hypertension in our series; there were significant differences as respect to percentages of Child-Pugh class B/C and blood platelet counts between HREV and non-HREV groups (P＜0.05); PVD and SVD in HREV group were (16.7±3.1)mm and (11.2±2.1)mm, both significantly greater than [(13.4±1.7) mm and (8.6±1.7)mm, respectively, P＜0.05], while PVVmax and SVVmax were (12.6±2.4)cm/s and (14.3±3.0) cm/s, both significantly less than [(15.7±1.9)cm/s and (17.2±2.1)cm/s, respectively, P＜0.05] in non-HREV group; LSM and SSM were (18.4±3.8)kPa and (31.5±6.4)kPa, both much greater than [(12.3±2.4)kPa and (25.7±5.8)kPa, respectively, P＜0.05] in non-HREV group; multivariate Logistic regression analysis showed that PVD and LSM were independent risk factors impacting occurrence of HREV, while the PVVmax was a protecting factor (all P＜0.05); ROC analysis demonstrated that PVD, PVVmax and LSM had a diagnostic efficacy in predicting existence of HREV (Z=2.87, P=0.13; Z=2.74, P=0.15; Z=2.35, P=0.37), while combination of the three parameters could improve specificity with a slight reduction of sensitivity. Conclusion Ultrasonography and SWE have a certain clinical implication in predicting occurrence of HREV in cirrhotics with portal hypertension, which warrants further investigation.

Key words: Liver cirrhosis, High risk esophageal varices, Portal vein diameter, Shear wave elastography, Diagnosis

Si Tong, Zhu Jiabao, Wu Binbin. Ultrasonography and shear wave elastography in predicting high risk esophageal varices in patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2025, 28(1): 100-103.

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Ultrasonography and shear wave elastography in predicting high risk esophageal varices in patients with liver cirrhosis

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