磁共振弹性成像检测脾脏硬度对预测肝硬化患者食管静脉曲张的价值。
Diagnostic value of spleen stiffness by magnetic resonance elastography for prediction of esophageal varices in cirrhotic patients.
机构信息
Department of Medical Imaging, Changhua Christian Hospital, No. 135, Nan-Hsiao Street, Changhua, 500, Taiwan.
Transplant Medicine and Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan.
出版信息
Abdom Radiol (NY). 2021 Feb;46(2):526-533. doi: 10.1007/s00261-020-02628-x. Epub 2020 Jul 16.
PURPOSE
To evaluate the diagnostic value of spleen stiffness (SS) via magnetic resonance elastography (MRE) in predicting esophageal varices.
METHODS
From January 2016 to September 2018, we retrospectively reviewed 263 patients with esophagogastroduodenoscopy (EGD) records and available spleen and liver stiffness (LS) values from MRE. Clinical information including the underlying diseases, endoscopic grade of esophageal varices (EV) and laboratory data were collected from electronic medical records.
RESULTS
In cirrhotic patients, MRE-SS was higher in those with EV than in those without. MRE-SS also showed significant association with EV in the multivariate analysis, whereas MRE-LS did not. The diagnostic performance of MRE-SS for EV in cirrhotic patients was demonstrated by the area under curve of 0.853 (cut-off value: 9.53 kPa, P < 0.001), 84.4% sensitivity and 73.7% specificity.
CONCLUSION
For prediction of EV in cirrhotic patients, MRE-SS is a useful non-invasive tool and it demonstrates better diagnostic performance than MRE-LS does.
目的
评估磁共振弹性成像（MRE）检测脾脏硬度（SS）在预测食管静脉曲张中的诊断价值。
方法
回顾性分析 2016 年 1 月至 2018 年 9 月期间 263 例接受食管胃十二指肠镜（EGD）检查且有 MRE 脾脏和肝脏硬度（LS）值的患者记录。从电子病历中收集了包括基础疾病、食管静脉曲张（EV）内镜分级和实验室数据在内的临床信息。
结果
在肝硬化患者中，有 EV 的患者的 MRE-SS 高于无 EV 的患者。多变量分析显示 MRE-SS 与 EV 也有显著相关性，而 MRE-LS 则没有。MRE-SS 对肝硬化患者 EV 的诊断性能表现为曲线下面积为 0.853（截断值：9.53 kPa，P < 0.001），灵敏度为 84.4%，特异性为 73.7%。
结论
对于预测肝硬化患者的 EV，MRE-SS 是一种有用的无创工具，其诊断性能优于 MRE-LS。
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