Bintintan Adriana, Chira Romeo Ioan, Bintintan Vasile Virgil, Nagy Georgiana Anca, Manzat-Saplacan Maria Roberta, Lupsor-Platon Monica, Stefanescu Horia, Duma Maria Magdalena, Valean Simona Doina, Mircea Petru Adrian
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. E-mail:
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Med Ultrason. 2015 Mar;17(1):5-11. doi: 10.11152/mu.2013.2066.171.abric.
Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with hepatic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters.
Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogastroduodenoscopy.
Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical significance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) >/= 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa.
Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.
需要采用非侵入性方法来诊断肝硬化患者食管静脉曲张的存在及其分级，在这方面我们评估了瞬时弹性成像和腹部超声参数的作用。
对肝硬化患者采用瞬时弹性成像和多普勒超声进行前瞻性评估，以诊断食管静脉曲张的存在及其分级，并将结果与食管胃十二指肠镜检查的结果进行比较。
分析了60例肝硬化患者。对诊断食管静脉曲张具有统计学意义的参数为：肝脏硬度（LSM）>15kPa、血流动力学肝脏指数（PVr1）≥0.66、门静脉血管阻力（PVR）>17.66和脾门静脉指数（SPI）>4.77。诊断大食管静脉曲张具有统计学效力的唯一参数是LSM，临界值为28.8kPa。
对肝硬化患者的LSM评估可预测食管静脉曲张和大食管静脉曲张的存在。PVr1、PVR和SPI多普勒指数可用于诊断食管静脉曲张的存在，但对大食管静脉曲张的预测无作用。需要进一步研究来证实这些结果并提供更强的临床意义。
