Role of shear wave elastography of liver and spleen “as non-invasive method” in prediction of oesophgeal varices in Egyptian patients with liver cirrhosis.

Abstract

ABSTRACT BACKGROUND: Upper gastrointestinal endoscopy (UGIE) screening for esophageal varices (EVs) is expensive for the health care system and invasive for the patients. Elastography has been recently used for prediction of liver cirrhosis and its complications. OBJECTIVE: To identify the reliability of liver stiffness (LS) and spleen stiffness (SS) using point shear wave elastography(PSWE) as noninvasive predictors of EVs. METHODS: Sixty patients divided into two groups (cirrhotics without EVs (30 patients) and cirrhotics with EVs (30 patients)) were subjected to: Demographic, clinical, laboratory tests, abdominal ultrasound and LS and SS measured by shear wave elastography (PSWE), and finally UGIE.60 healthy control subjects were also included in the study. RESULTS: There was highly significant increase of liver , spleen stiffness, and liver stiffness ᵡ splenic size/platelet count(LSPS) in group with EVs in comparison to group without EVs and control group, and in patients group with cirrhosis without EVs in comparison to control. Also there was significant increase of spleen stiffness in cases with large EVs than in those with mild and moderate EVs while there was no significant difference as regard liver stiffness.CONCLUSION: LS and SS are reliable predictive tools for EVs. These results could be used to reduce the need for routine upper gastrointestinal endoscopy screening. Keywords: Noninvasive, PSWE, Liver Stiffness, Spleen Stiffness, esophageal varices