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The role of liver stiffness measurement in the evaluation of liver function and esophageal varices in cirrhotic patients
Author(s) -
Hua Jing,
Liu Gui Qin,
Bao Han,
Sheng Li,
Guo Can Jie,
Li Hai,
Ma Xiong,
Shen Jia Lin
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12210
Subject(s) - medicine , transient elastography , cirrhosis , esophagogastroduodenoscopy , esophageal varices , gastroenterology , endoscopy , elastography , liver function , radiology , portal hypertension , ultrasound , liver fibrosis
Objective We aimed to evaluate the efficacy of liver stiffness measurement ( LSM ) in predicting the presence and severity of esophageal varices ( EV ) and investigating its association with liver function (LF) in patients with liver cirrhosis. Methods Medical records of 90 cirrhotic patients who underwent LSM by transient elastography were retrospectively reviewed. The relationship between LSM and the presence and severity of EV was evaluated by esophagogastroduodenoscopy ( EGD ) and multislice spiral computed tomography (MS CT ). Another 25 healthy individuals were included as controls. Results LSM was significantly associated with the Child–Pugh score in cirrhotic patients, with the highest LSM in those with Child–Pugh C . Patients with clinically decompensated cirrhosis had a higher LSM than those with compensated cirrhosis (36.75 ± 16.54 kPa vs 17.65 ± 10.87 kPa, P < 0.01). However, there was no significant difference in LSM value between patients with severe EV and those with no or non‐severe EV determined by endoscopy (28.18 ± 17.44 kPa vs 31.00 ± 18.44 kPa) or MS CT (29.71 ± 18.39 kPa vs 24.90 ± 14.80 kPa). The diagnostic value of LSM for predicting severe EV was low in unselected cirrhotic patients. The presence of EV examined by EGD and MS CT was similar to each other. Conclusions LSM could be used to evaluate the progression of liver cirrhosis continuously. However, its role in assessing EV grades in advanced cirrhosis needs further confirmation. MS CT can assess EV accurately and may serve as an alternative to endoscopy in the assessment of portal hypertension.