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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 5
May  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(5): 1081-1084

Clinical value of two-dimensional shear wave elastography in predicting esophageal varices in patients with hepatitis B cirrhosis by evaluating liver and spleen stiffness

DOI: 10.3969/j.issn.1001-5256.2021.05.021

  • Department of Ultrasound, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

  • Received Date: 2020-10-22
  • Accepted Date: 2020-12-02
  • Published Date: 2021-05-20
    Abstract
  •   Objective  To investigate the value of two-dimensional shear wave elastography (2D-SWE) in the noninvasive evaluation of the presence or absence of esophageal varices (EV) in patients with hepatitis B cirrhosis by liver stiffness measurement (LSM) and spleen stiffness measurement (SSM).  Methods  A total of 172 patients who were diagnosed with hepatitis B cirrhosis in Beijing Ditan Hospital, Capital Medical University, from April 2019 to February 2020 were enrolled in a prospective study, and according to the results of gastroscopy, they were divided into non-EV group and EV group. The two groups were compared in terms of spleen thickness (ST), spleen diameter (SD), LSM, and SSM. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data. The receiver operating characteristic (ROC) curve was used to investigate the value of LSM and SSM in the diagnosis of EV, and the Z test was used to compare the diagnostic accuracy of LSM and SSM.  Results  There were 121 patients in the EV group and 51 patients in the non-EV group. There were significant differences between the two groups in ST (t=8.143, P < 0.001), SD (t=7.363, P < 0.001), LSM (Z=3.024, P=0.002), SSM (t=15.142, P < 0.001), and presence or absence of ascites (χ2=22.101, P < 0.001). LSM had an area under the ROC curve (AUC) of 0.646 (95% confidence interval [CI]: 0.570-0.718) in the diagnosis of EV, with a sensitivity (Se) of 83.47%, a specificity (Sp) of 47.06%, a positive predictive value (PPV) of 78.9%, and a negative predictive value (NPV) of 54.5% at the optimal cut-off value of 13.16. SSM had an AUC of 0.951 (95% CI: 0.907-0.978) in the diagnosis of EV, with an Se of 80.99%, an Sp of 96.08%, a PPV of 98.0%, and an NPV of 68.1% at the optimal cut-off value of 38.08. SSM had a better diagnostic accuracy than LSM (Z=6.096, P < 0.001).  Conclusion  LSM and SSM can be used to predict the presence or absence of EV in patients with hepatitis B cirrhosis. SSM has a higher accuracy than LSM and can provide accurate diagnostic information for clinical practice.

     

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