| Usefulness of Liver stiffness measurement for predicting the presence of esophageal varices in patients with Liver cirrhosis |
| Hyuk Sang Jung, M.D., Yun Soo Kim, M.D., Oh Sang Kwon, M.D.,
Yang Suh Ku, M.D., Yu Kyung Kim, M.D.,
Duck Joo Choi, M.D., Ju Hyun Kim, M.D. |
| Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea |
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| ABSTRACT |
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Background/Aims
Bleeding from esophageal varices (EV) is a major cause of death in patients with liver
cirrhosis. Endoscopic screening is recommended for diagnosing EV, but various noninvasive parameters can
also be used to predict EV. The liver stiffness measurement (LSM), a noninvasive technique for estimating
liver fibrosis, was recently reported to be strongly correlated with the hepatic venous pressure gradient. This
study evaluated the usefulness of LSM for predicting the presence and size of EV in patients with cirrhosis.
Methods
The relationships of LSM with the presence and size of EV were analyzed in 112 patients with liver
cirrhosis. Liver cirrhosis was diagnosed histologically or clinically. The presence and size of EV were assessed
by endoscopy, and LSM was determined by the FibroscanⓇ technique. Results: LSM was strongly correlated
with the presence of EV (P<0.0001): the LSM value was 42.7±21.9 kPa (mean±standard deviation) in patients
with EV (n=82) and 19.1±12.6 kPa in patients without EV (n=30). The area under the receiver operating
characteristic curve was 0.818 (95% CI, 0.732-0.904) for predicting the presence of EV, and an LSM value of
19.7 kPa was predictive of the presence of EV with a sensitivity of 87%, a specificity of 70%, a PPV of 89%,
and a NPV of 66%. However, there was a weak correlation between LSM and the size of EV. Conclusions:
LSM is useful for predicting the presence of EV in patients with cirrhosis but not their size. (Korean J
Hepatol 2008;14:342-350) |
| KeyWords:
Liver Cirrhosis; Esophageal varices; Liver stiffness measurement |
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