Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, People's Republic of China.
Sichuan University-University of Oxford Huaxi Joint for Gastrointestinal Cancer Centre, Chengdu, People's Republic of China.
Eur Radiol. 2022 Mar;32(3):2078-2088. doi: 10.1007/s00330-021-08280-3. Epub 2021 Oct 29.
To investigate the usefulness of the criteria with liver stiffness (LS) measured by two-dimensional shear wave elastography (2D-SWE) and platelet count (PLT) for ruling out high-risk varices in patients with compensated advanced chronic liver disease (cACLD).
A total of 661 patients with cACLD had successfully undergone 2D-SWE and endoscopy screening. We analyzed risk factors for the presence of high-risk varices and compared proportions of patients who were spared endoscopy when used the predicting criteria with LS (ranged from 16 to 25 kPa) and PLT (ranged from 80 × 10/L to 150 × 10/L).
PLT, albumin, LS were found to be independent predictors of high-risk varices. The LS values for ruling out and ruling in high-risk varices were 14.0 kPa and 24.8 kPa, respectively. When the Baveno VI criteria LS < 20 kPa and PLT > 150 × 10/L were used, the high-risk varices miss rate was 2.1%, while the saved endoscopy rate only was 19.2%. The new criteria that LS < 16 kPa and PLT > 100 × 10/L saved 30.4-34.6% endoscopy with 0-3.2% high-risk varices miss rate in the subgroup analysis stratified according to the types of underlying liver disease.
The Baveno VI criteria can be applied to LS measurement by 2D-SWE. The new criteria that LS < 16 kPa and PLT > 100 × 10/L could be a potential model to spare more endoscopy screening with < 5% high-risk varices miss rate.
• LS measured by 2D-SWE is reliable predictive factor for predicting all-size varices and high-risk varices in patients with compensated advanced chronic liver disease. • LS measured by 2D-SWE < 16 kPa and PLT > 100 × 10 /L, which can spare more endoscopy than Baveno VI criteria with < 5% high-risk varices miss rate. • The Baveno VI criteria can be applied to LS measurement by 2D-SWE.
探讨二维剪切波弹性成像（2D-SWE）测量的肝硬度（LS）和血小板计数（PLT）标准在排除代偿期慢性肝病晚期（cACLD）患者高危静脉曲张中的作用。
共 661 例 cACLD 患者成功接受 2D-SWE 和内镜筛查。分析存在高危静脉曲张的危险因素，并比较使用 LS（范围为 16-25kPa）和 PLT（范围为 80×10/L-150×10/L）预测标准时避免内镜检查的患者比例。
PLT、白蛋白和 LS 是高危静脉曲张的独立预测因素。LS 用于排除和确诊高危静脉曲张的界值分别为 14.0kPa 和 24.8kPa。当使用 Baveno VI 标准 LS<20kPa 和 PLT>150×10/L 时，高危静脉曲张漏诊率为 2.1%，而节省的内镜检查率仅为 19.2%。在根据基础肝病类型分层的亚组分析中，新的 LS<16kPa 和 PLT>100×10/L 标准可节省 30.4-34.6%的内镜检查，高危静脉曲张漏诊率为 0-3.2%。
Baveno VI 标准可应用于 2D-SWE 测量的 LS。LS<16kPa 和 PLT>100×10/L 的新标准可以节省更多的内镜检查，高危静脉曲张漏诊率<5%。
2D-SWE 测量的 LS 是预测代偿期慢性肝病晚期患者所有大小静脉曲张和高危静脉曲张的可靠预测因素。
2D-SWE 测量的 LS<16kPa 和 PLT>100×10/L，可以比 Baveno VI 标准节省更多的内镜检查，高危静脉曲张漏诊率<5%。
Baveno VI 标准可应用于 2D-SWE 测量的 LS。
