scholarly journals Assessing Baveno VI Criteria Using Liver Stiffness Measured with a 2D-Shear Wave Elastography Technique

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 737
Author(s):  
Renata Fofiu ◽  
Felix Bende ◽  
Alina Popescu ◽  
Roxana Șirli ◽  
Bogdan Miuţescu ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Esophageal Varices ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Abdominal Ultrasound ◽  
Gastric Varices ◽  
Digestive Endoscopy ◽  
Spleen Stiffness ◽  
Upper Digestive Endoscopy

The present study evaluates the performance of Baveno VI criteria, using liver stiffness (LS) assessed with a 2D-SWE elastography technique, for predicting high-risk varices (HRV) in patients with compensated advanced chronic liver disease (cACLD). A secondary aim was to determine whether the use of spleen stiffness measurements (SSMs), as additional criteria, increases the performance of the 2D-SWE Baveno VI criteria. Data were collected from 208 subjects with cACLD, who underwent abdominal ultrasound, liver and spleen stiffness measurements, and upper digestive endoscopy. HRV were defined as grade 1 esophageal varices (EV) with red wale marks, grade 2/3 EV, and gastric varices. A total of 35.6% (74/208) of the included subjects had HRV. The optimal LS cut-off value for predicting HRV was 12 kPa (AUROC-0.80). Using both LS cut-off value < 12 kPa and a platelet cut-off value > 150 × 109 cells/L as criteria to exclude HRV, 52/208 (25%) subjects were selected, 88.5% (46/52) were without EV, 9.6% (5/52) had grade 1 EV, and 1.9% (1/52) had HRV. Thus 98% of the subjects were correctly classified as having or not having HRV and 25% of the surveillance endoscopies could have been avoided. Using SS < 13.2 kPa and a platelet cut-off value > 150 × 109 cells/L as additional criteria for the patients that were outside the initial ones, 32.7% of the surveillance endoscopies could have been avoided.

scholarly journals Point Shear Wave Elastography of the Spleen in Predicting the Presence of Esophageal Varices in Cirrhosis: Liver Stiffness vs. Spleen Stiffness

2019 ◽  
Vol 36 (2) ◽  
pp. 95-101
Author(s):  
Nadella Sindhu ◽  
Prakashini Koteshwar ◽  
Shiran Shetty
Keyword(s):  
Esophageal Varices ◽  
Statistical Tests ◽  
Characteristic Curve ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Significant Difference ◽  
Spleen Stiffness ◽  
Cirrhotic Patients ◽  
The Difference ◽  
Combined Parameters

Objective: To determine the diagnostic ability of the spleen and liver stiffness in predicting the presence of esophageal varices (EVs). Methods: A sample of cirrhotic patients, diagnosed with sonography, was recruited. The cohorts’ liver stiffness (LS) and spleen stiffness (SS) were measured with the Philips’ Elast PQ technique. Platelet count and spleen size were also documented. The endoscopic report was used as the diagnostic gold standard. Singular and combined parameters were assessed to determine the presence of EV using an independent variable t test, area under the receiver operating characteristic curve, and multilogistic regression analysis statistical tests. Results: In predicting the presence of EV, there was a statistically significant difference in means of SS (2.13 ± 0.69 m/s vs. 3.23 ± 1.32 m/s) and LS (2.33 ± 1.20 m/s vs. 3.05 ± 1.4 m/s), as well as discriminating between groups of patients, with and without EV. The ability to diagnostically classify EV with SS and LS was fair while the remaining parameters were deemed poor, using a SS cutoff value of 1.99 m/s. Conclusion: Despite the difference in means, none of the assessed parameters demonstrated a better classification ability than endoscopy. LS and SS were equal in the prediction of EV in these patients. The LS estimate of fibrosis would have grossly predicted the presence of varices. However, the addition of SS, for the estimation of varices, provided no significant benefit.

Changes in Liver and Spleen Stiffness by Virtual Touch Quantification Technique after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices and Exacerbation of Esophageal Varices: A Preliminary Study

2019 ◽  
Vol 41 (02) ◽  
pp. 157-166
Author(s):  
Yoshitaka Takuma ◽  
Youichi Morimoto ◽  
Hiroyuki Takabatake ◽  
Junko Tomokuni ◽  
Akiko Sahara ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Venous Pressure ◽  
Portal Pressure ◽  
Liver Stiffness ◽  
Roc Curves ◽  
Gastric Varices ◽  
Roc Curve Analysis ◽  
Before And After ◽  
Spleen Stiffness ◽  
Preliminary Study

Abstract Purpose To assess liver stiffness (LS) and spleen stiffness (SS) values measured by virtual touch quantification (VTQ) technique in the monitoring of portal pressure and their usefulness for the prediction of the exacerbation of esophageal varices (EV) in patients with gastric varices undergoing balloon-occluded retrograde transvenous obliteration (B-RTO). Materials and Methods The LS, SS, and hepatic venous pressure gradient (HVPG) were measured in 20 patients both before and after B-RTO. The change in each parameter between the two groups (EV exacerbation and non-exacerbation groups) was compared by analysis of variance. The efficacy of the parameters for the prediction of the exacerbation of EV was analyzed using a receiver operating characteristic (ROC) curve analysis. Results 9 patients (40.9 %) exhibited an exacerbation of EV within 24 months after B-RTO. Significant changes were observed in the HVPG and SS after B-RTO between the two groups (EV exacerbation group vs. non-exacerbation group: HVPG before 12.7 ± 4.4 mmHg vs. 11.0 ± 4.4 mmHg; HVPG after 19.6 ± 6.0 mmHg vs. 13.6 ± 3.1 mmHg P = 0.003; SS before 3.40 ± 0.50 m/s vs. 3.20 ± 0.51 m/s; SS after 3.74 ± 0.53 m/s vs. 3.34 ± 0.43 m/s P = 0.016). However, no significant changes in LS were observed between the two groups. The area under the ROC curves of elevation in HVPG and SS for the prediction of the exacerbation of EV after B-RTO were 0.833 and 0.818, respectively. Conclusion Elevation of the HVPG and SS measured by VTQ after B-RTO was useful for the prediction of the exacerbation of EV.

Application of Supersonic Shear Imaging to the Baveno VI Criteria and a Combination Model with Spleen Stiffness Measurement to Rule Out High-Risk Varices in Compensated Advanced Chronic Liver Disease

2020 ◽  
Author(s):  
Young Seo Cho ◽  
Yongsoo Kim ◽  
Joo Hyun Sohn
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Chronic Liver Disease ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Screening Endoscopy ◽  
Supersonic Shear Imaging ◽  
Spleen Stiffness ◽  
Sequential Combination ◽  
Rule Out

Abstract Purpose Recently, Colecchia et al. reported that by adding a spleen stiffness (SS) criterion sequentially to the Baveno VI criteria, screening endoscopy could be safely avoided. We aimed to compare the Baveno VI criteria, SS values and a sequential combination of the Baveno VI and SS values, measured by supersonic shear imaging (SSI), as approaches for safely avoiding screening endoscopy for high-risk varices (HRV). Materials and Methods Between April 2017 and July 2018, we enrolled 274 compensated advanced chronic liver disease patients who had successfully undergone liver stiffness (LS) and SS measurements with SSI and esophagogastroduodenoscopy (EGD). 52 HRV patients were included, and we analyzed risk factors for HRV and compared proportions of patients who were spared EGD when Baveno VI criteria, SS cut-off and the combination of the two approaches were used. Results The AUROC values for estimating HRV by platelet count, LS and SS were 0.701, 0.757 and 0.844, respectively, and all three measures were found to be independent predictors of HRV. The SS cut-off value for excluding HRV was ≤ 27.3 kPa. The percentages of patients spared EGD were 18.6 % for Baveno VI, 28.8 % for SS cut-off and 36.1 % for the sequential combination of Baveno VI and SS cut-off. Less than 2 % of HRV patients were missed when using all of the criteria. Conclusion The Baveno VI criteria can be applied to LS measurement by SSI. SS measurement by SSI is an excellent predictor of HRV. Screening endoscopy can be safely avoided when Baveno VI criteria and SS cut-off are applied together.

scholarly journals Spleen Stiffness Is Superior to Liver Stiffness for Predicting Esophageal Varices in Chronic Liver Disease: A Meta-Analysis

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165786 ◽  
Author(s):  
Xiaowen Ma ◽  
Le Wang ◽  
Hao Wu ◽  
Yuemin Feng ◽  
Xibiao Han ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Meta Analysis ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Spleen Stiffness

scholarly journals Spleen Stiffness as Predictor of Esophageal Varices in Cirrhosis of Different Etiologies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Carmen Fierbinteanu-Braticevici ◽  
Laura Tribus ◽  
Razvan Peagu ◽  
Ana Petrisor ◽  
Cristian Baicus ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Radiation Force ◽  
Abdominal Ultrasound ◽  
Acoustic Radiation Force Impulse ◽  
P Value ◽  
Upper Gastrointestinal Endoscopy ◽  
Spleen Stiffness ◽  
Excellent Method

Abstract The purpose of this study is to determine whether esophageal varices (EV) can be identified through the evaluation of spleen stiffness (SSM) via acoustic radiation force impulse (ARFI). A total of 135 patients suffering from cirrhosis underwent a clinical exam, laboratory tests, abdominal ultrasound, liver stiffness (LSM) measurement, SSM evaluation and upper gastrointestinal endoscopy. Based on the endoscopy results, the patients were classified into three groups: those with no evident EV, those with small EV and those with varices needing treatment (VNT). Patients with EV of any grade had significantly higher average SSM values over those with no EV (3.37 m/s versus 2.79 m/s, p-value < 0.001), while patients with VNT showed an even greater difference (3.96 m/s versus 2.93 m/s, p-value < 0.001). SSM proved to be an excellent method of predicting patients with VNT.

scholarly journals Liver stiffness-spleen size-to-platelet ratio risk score detects esophageal varices in chronic liver disease

SpringerPlus ◽  
2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Soichiro Shibata ◽  
Satoru Joshita ◽  
Takeji Umemura ◽  
Tomoo Yamazaki ◽  
Naoyuki Fujimori ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Risk Score ◽  
Esophageal Varices ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Spleen Size
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