389 LONG-TERM EVALUATION OF FIBROSIS BY TRANSIENT ELASTOGRAPHY IN PATIENTS CLEARING HCV ON ANTIVIRAL THERAPY

Abstract

was unreliable in 15 obese patients(8.9%). 54 patients (37.5%) had an histological and 90 (62.5%) a clinical diagnosis of cirrhosis. All patients underwent endoscopy. LS and SS were measured under US control. Results: In the subgroup with haemodinamic evaluation, we found a significant correlation between HVPG value and SSM(Linear regression analysis: r = 0.671; p =0.009). 9 of them had the highest SS value(75 kPa). Mean HVPG was significant different between patients with SSM lower or equal 75 kPa(12.5mmHg vs 19.1mmHg, p =0.013) without significant differences for bilirubin, albumin or INR values(p=ns). All 9 patients with SSM=75kPa had large esophageal varices(6 F2, 3 F3). In the whole cohort of patients, 80 (55.6%) had EV and 28 (19.4%) had large EV(F2 or F3). The AUROCs of LS and SS were almost the same(0.76 vs 0.73) for the prediction of EV but SSM was significantly better than LSM to predict large EV(AUROCs:0.84 vs 0.72). The best cut-offs of LS and SS for the diagnosis of cirrhosis with EV were 21kPa(Sens. 71%, Spec. 72%) and 47kPa(Sens. 79%, Spec. 70%) respectively. Twenty-four patients with a LSM <21kPa had EV and 6 of them had large EV. Seventeen patients with SSM <47 had varices but none of them had a diagnosis of large varices(NPV=100%). Conclusion: The stiffness of the spleen correlates with portal hypertension. Hence the measurement of SS in patients with cirrhosis adds to the accuracy of TE as a non-invasive tool to predict the presence of esophageal varices.