Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania.
Ann Hepatol. 2012 Jul-Aug;11(4):519-25.
To establish an algorithm which includes the liver stiffness (LS) and/or spleen stiffness (SS) assessed by ARFI for the prediction of significant esophageal varices-EV (at least grade 2).
Our study included 145 newly diagnosed cirrhotic patients admitted in our Department between September 2009-August 2011. 62 patients (42.7%) had significant EV. We performed 10 ARFI measurements in each patient, both in the liver and in the spleen; median values were calculated, expressed in meters/second. In 24 consecutive newly diagnosed cirrhotic patients admitted between September 2011-December 2011, we prospectively analyzed the value of the new score for predicting significant EV.
The LS and SS assessed by ARFI elastography, and the percentage of patients with ascites were stastically significant higher in patients with significant EV as compared with those without EV or grade 1 EV. By multiple regression analysis we obtained the following formula for predicting significant EV: prediction of significant EV (Pred EV(2-3)) score: -0.572 + 0.041 x LS (m/s) + 0.122 x SS (m/s) + 0.325 x ascites (1-absent, 2-present). The best Pred EV(2-3) cut-off value for predicting significant EV was > 0.395 (AUROC = 0.721, accuracy = 69.6%). The accuracy in the group of patients in which the value of this score was prospectively analyzed was similar with that obtained in the first cohort of patients (70.8 vs. 69.6%). In conclusion, the proposed Pred EV(2-3) score had a enough good value for predicting significant EV.
建立一种算法，该算法包括通过声辐射力脉冲（ARFI）评估的肝硬度（LS）和/或脾硬度（SS），用于预测有意义的食管静脉曲张-EV（至少为 2 级）。
我们的研究包括 2009 年 9 月至 2011 年 8 月期间我院收治的 145 例新诊断的肝硬化患者。62 例（42.7%）有明显的 EV。我们对每个患者进行了 10 次 ARFI 测量，分别在肝脏和脾脏进行；计算中位数，以米/秒表示。在 2011 年 9 月至 2011 年 12 月期间连续收治的 24 例新诊断的肝硬化患者中，我们前瞻性分析了新评分预测有意义的 EV 的价值。
与无 EV 或 1 级 EV 的患者相比，通过 ARFI 弹性成像评估的 LS 和 SS，以及有腹水的患者比例均有统计学意义的升高。通过多元回归分析，我们得出了以下预测有意义的 EV 的公式：预测有意义的 EV（预测 EV(2-3)）评分：-0.572+0.041×LS（m/s）+0.122×SS（m/s）+0.325×腹水（1-无，2-有）。预测有意义的 EV 的最佳 Pred EV(2-3)截断值>0.395（AUROC=0.721，准确性=69.6%）。在对该评分值进行前瞻性分析的患者组中的准确性与在第一组患者中获得的准确性相似（70.8%对 69.6%）。总之，提出的 Pred EV(2-3)评分对预测有意义的 EV 具有足够好的价值。
