Diagnostic Performance of Shear Wave Elastography Ultrasound for Identification of Esophageal Varices Needing Treatment in Initially Diagnosed Patients of Compensated Cirrhotic Liver

Abstract

ABSTRACT Background: The presence of varices in liver cirrhosis patients is an important risk factor for death and decompensation. Ultrasound elastography can be a noninvasive alternative to estimate portal hypertension severity and to predict varices. Objective: Our study was performed to evaluate the diagnostic performance of liver stiffness (LS) and splenic stiffness (SS) measured by 2D shear wave elastography (SWE) and correlate it with endoscopic findings for the accuracy of assessment of varices needing treatment (VNT) in compensated liver cirrhosis patients. Patients and methods: This is a prospective study that included 150 patients who had compensated liver cirrhosis. Two dimensional shear wave elastography measurements for liver and spleen stiffness were obtained and upper gastrointestinal endoscopies for the presence and grade of varices were performed. Results: We found that as liver or spleen stiffness increases, the more is the increase in the size of the varices with significant positive linear correlation (p value < 0.001). We tried to identify the value of liver/spleen stiffness, which could predict presence of significant varices. Multivariate analysis identified several factors that could be associated with high risk varices, including liver and spleen elastography (p < 0.001). Conclusion: Shear wave elastography is an effective and noninvasive tool not only for staging of fibrosis, but also for predicting clinically significant portal hypertension.