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

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Abstract

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.

Original languageEnglish
JournalJournal of Diagnostic Medical Sonography
DOIs
Publication statusAccepted/In press - 01-01-2019

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Elasticity Imaging Techniques
Esophageal and Gastric Varices
Liver Cirrhosis
Spleen
Liver
Varicose Veins
Platelet Count
ROC Curve
Endoscopy
Ultrasonography
Fibrosis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{19c606bd19654cab9f70782be8c7158f,
title = "Point Shear Wave Elastography of the Spleen in Predicting the Presence of Esophageal Varices in Cirrhosis: Liver Stiffness vs. Spleen Stiffness",
abstract = "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.",
author = "Nadella Sindhu and Prakashini Koteshwar and Shiran Shetty",
year = "2019",
month = "1",
day = "1",
doi = "10.1177/8756479319882006",
language = "English",
journal = "Journal of Diagnostic Medical Sonography",
issn = "8756-4793",
publisher = "SAGE Publications Inc.",

}

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T1 - Point Shear Wave Elastography of the Spleen in Predicting the Presence of Esophageal Varices in Cirrhosis

T2 - Liver Stiffness vs. Spleen Stiffness

AU - Sindhu, Nadella

AU - Koteshwar, Prakashini

AU - Shetty, Shiran

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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