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Usefulness of MR elastography for predicting esophageal varices in cirrhotic patients
Author(s) -
Sun Hye Young,
Lee Jeong Min,
Han Joon Koo,
Choi Byung Ihn
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24186
Subject(s) - esophageal varices , varices , medicine , magnetic resonance elastography , elastography , cirrhosis , receiver operating characteristic , portal hypertension , gastroenterology , endoscopy , radiology , ultrasound
Purpose To evaluate the usefulness of magnetic resonance elastography (MRE) as a noninvasive tool for predicting esophageal varices and identifying high‐risk varices. Materials and Methods In all, 126 patients with liver cirrhosis, and who underwent both MRI including MRE of the liver as well as upper gastrointestinal endoscopy for variceal screening within 1 month before or after the MRI, were included in this study. The relationship between the liver stiffness values measured by MRE and the degree of esophageal varices was assessed using Spearman's correlation analysis. In addition, the diagnostic performance of MRE for predicting the presence of varices or high‐risk varices (grade ≥II) was evaluated using the receiver‐operating characteristics (ROC) curves. Results The mean stiffness values of liver parenchyma measured on MRE were well correlated with the grade of esophageal varices ( r = 0.63). In addition, the MRE‐based liver stiffness values were significantly lower in the lower‐risk group than in the higher‐risk group ( P < 0.0001). The area under the ROC curve values of MRE for predicting the presence of varices or high‐risk varices (grade ≥II) were 0.859 and 0.810, respectively. Using a liver stiffness cutoff value of 5.803 kPa, the sensitivity, specificity, positive predictive value, and negative predictive value for predicting high‐grade (≥II) esophageal varices were 96%, 60%, 36%, and 98%, respectively. Conclusion The MRE‐based liver stiffness value may be useful for noninvasively predicting esophageal varices and identifying high‐risk varices in cirrhotic patients. J. Magn. Reson. Imaging 2014;39:559–566 . © 2013 Wiley Periodicals, Inc .