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CN 22-1108/R
Volume 38 Issue 7
Jul.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(7): 1554-1560

Value of ultrasonic shear-wave dispersion imaging in diagnosis of high-risk esophageal and gastric varices in compensated cirrhosis

DOI: 10.3969/j.issn.1001-5256.2022.07.018
  • 1.

    The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China

  • 2a.

    Department of Ultrasound, , Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

  • 2b.

    Department of Hepatology and Gastroenterology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

Research funding:

Tianjin Science and Technology Major Project and Critical Disease Prevention and Control Project 2019 (19ZXDBSY00030)

More Information
  • Corresponding author: XIANG Huiling, huilingxiang@163.com(ORCID: 0000-0003-3678-4225)
  • Received Date: 2021-10-30
  • Accepted Date: 2021-12-17
  • Published Date: 2022-07-20
    Abstract
  •   Objective  To investigate the clinical value of Canon two-dimensional ultrasound shear wave elastography (SWE) and shear wave dispersion (SWD) in the diagnosis of high-risk esophageal and gastric varices in compensated cirrhosis.  Methods  A total of 58 patients with compensated cirrhosis of various etiologies who received electronic gastroscopy in Tianjin Third Central Hospital from February 2020 to February 2021, and Canon Aplio i800 color ultrasound instrument was used to perform SWE and SWD of the liver. According to the results of gastroscopy, the patients were divided into high-risk esophageal and gastric varices group (HREGV group) with 22 patients and non-high-risk esophageal and gastric varices group (NHREGV group) with 36 patients. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the non-parametric 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 between two groups. A multivariate logistic regression analysis was used to analyze and screen out the noninvasive indicators for predicting high-risk esophageal and gastric varices, and the receiver operating characteristic (ROC) curve was used to evaluate the clinical value of liver SWD and SWE in the diagnosis of high-risk esophageal and gastric varices.  Results  There were significant differences between the HREGV group and the NHREGV group in SWD (t=-3.84, P < 0.001), etiology (χ2=9.67, P=0.022), total bilirubin (Z=-2.00, P=0.045), spleen diameter (t=-2.44, P=0.018), and portal vein diameter (Z=-1.96, P=0.005). The patients with compensated cirrhosis had a mean liver SWD of 15.17±2.45 m·s-1·kHz-1, and the HREGV group had a significantly higher liver SWD than the NHREGV group (16.59±2.66 m·s-1·kHz-1 vs 14.31±1.86 m·s-1·kHz-1, t=-3.84, P < 0.001), while there was no significant difference in SWE between the two groups (Z=-1.21, P=0.223). SWD was an independent risk factor for high-risk esophageal and gastric varices in patients with compensated liver cirrhosis (odds ratio=1.67, 95% confidence interval: 1.17-2.39, P=0.005). In the diagnosis of high-risk esophageal and gastric varices, SWD had an area under the ROC curve (AUC) of 0.786, with a specificity of 80.56% and a sensitivity of 81.82% at the optimal cut-off value of 15.35 m·s-1·kHz-1; SWE had an AUC of 0.596, with a specificity of 52.78% and a sensitivity of 68.18% at the optimal cut-off value of 9.25 kPa.  Conclusion  Liver SWD measured by Canon Aplio i800 color ultrasound is excepted to become a new noninvasive method to predict the presence of high-risk esophageal and gastric varices in patients with compensated cirrhosis, while SWE has a limited diagnostic value.

     

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