Transient Elastography (Fibroscan) for the Prediction of Esophageal Varices in Egyptian Cirrhotic Patients

Elkafoury, Rania Mamdouh and Kobtan, Abdelrahman Abdelraouf and Soliman, Hanan Hamed and Salah, Raafat Abdelkader (2022) Transient Elastography (Fibroscan) for the Prediction of Esophageal Varices in Egyptian Cirrhotic Patients. Journal of Advances in Medicine and Medical Research, 34 (24). pp. 39-50. ISSN 2456-8899

[thumbnail of 4902-Article Text-9298-1-10-20221222.pdf] Text
4902-Article Text-9298-1-10-20221222.pdf - Published Version

Download (367kB)

Abstract

Background: Esophageal varices (EVs) are atypically dilated submucosal veins, which occurs consequently to portal hypertension. Liver stiffness measurement (LSM), obtained by transient elastography (Fibroscan), strongly correlates with portal hypertension.

Aim: Is to predict the presence and grading of esophageal varices in Egyptian patients with liver cirrhosis using Fibroscan and other noninvasive tests.

Methods: A 101 cirrhotic patients indicated for upper endoscopy were enrolled consecutively and subdivided according to endoscopic findings into: Group I (70 patients with EVs) and Group II (31 patients without EVs). Upper endoscopy, ultrasonography, routine lab. and Fibroscan assessment were done to all patients.

Results: LSM correlated directly and significantly with the presence (p <0.001), and grading of EVs (p = 0.001). A LSM cut off value of 18.55 kPa had an AUC of 0.726, sensitivity of 74.3%, specificity of 54.8%, PPV of 78.79%, and a NPV of 48.57% for predicting the presence of EVs. Platelet count/spleen diameter ratio (PSR) inversely correlated with the EVs presence (p = 0.002), and grading (p <0.001). PSR had a cut off value of 742.17, an AUC of 0.695, sensitivity of 71% and a specificity of 58.6% (PPV of 82%, NPV of 43.14%) for EVs presence. Right lobe diameter/Albumin ratio (RLAR) correlated directly with EVs presence (p = 0.001), and grading (p =0.012). RLAR cut off value of 3.62 had AUC, sensitivity, specificity, PPV, and NPV of 0.7, 64.3%, 67.7%, 81.8%, and 45.7%, respectively for the prediction of EVs presence.

Conclusion: LSM, PSR, RLAR as noninvasive methods for predicting the presence and grading of EVs are of moderate accuracy.

Item Type: Article
Subjects: Institute Archives > Medical Science
Depositing User: Managing Editor
Date Deposited: 23 Dec 2022 10:08
Last Modified: 05 Jun 2024 09:26
URI: http://eprint.subtopublish.com/id/eprint/1284

Actions (login required)

View Item
View Item