Wada Azusa, Yamashita Yasunobu, Iguchi Mikitaka, Ida Yoshiyuki, Maekita Takao, Ashida Reiko, Kitano Masayuki
Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, Japan.
Diagnostics (Basel). 2025 Jul 25;15(15):1867. doi: 10.3390/diagnostics15151867.
: Esophageal varices (EVs) are a serious complication of liver cirrhosis. Guidelines for cirrhosis/chronic liver diseases (CLDs) do not specify a follow-up period or the need for esophagogastroduodenoscopy (EGD). EGD is a useful but uncomfortable procedure for the assessment of varices. Follow-up with abdominal ultrasonography (AUS) is recommended in patients with CLDs. If EVs are assessed by AUS, more patients eligible for endoscopic screening of EVs can be selected. We aimed to investigate whether AUS elastography [shear wave (Vs) and F-index] can predict the diagnosis, severity, and treatment indication of EVs. : Between April 2018 and October 2022, we retrospectively collected data of 194 patients who underwent elastography and EGD for CLDs. The correlations between Vs/F-index values and presence/severity of EVs were evaluated. Each cut-off value for diagnosis and treatment indication of EVs was investigated. : 85 patients without exclusion criteria were enrolled. Vs and F-index values were significantly higher in patients with EVs than in patients without EVs ( = 0.0005 and 0.0021, respectively) and positively correlated with severity of EVs. The cut-off Vs and F-index values for the presence of EVs were 1.63 m/s and 1.88, respectively, with 88.1%/83.3% sensitivity, 48.8%/51.2% specificity, and 0.71/0.70 area under the curve (AUC). The cut-off Vs and F-index values for treatment indication were 1.71 m/s and 2.08, respectively, with 100%/88.2% sensitivity, 45.6%/52.9% specificity, and 0.69/0.70 AUC. There were no significant differences between the two modalities. : Elastography may provide objective assessment and thus be a non-invasive screening tool for diagnosis and treatment indication of EVs.
食管静脉曲张（EVs）是肝硬化的一种严重并发症。肝硬化/慢性肝病（CLDs）指南未明确随访期限或食管胃十二指肠镜检查（EGD）的必要性。EGD是评估静脉曲张的一种有用但令人不适的检查方法。建议对CLDs患者进行腹部超声检查（AUS）随访。如果通过AUS评估EVs，可以筛选出更多适合进行内镜下EVs筛查的患者。我们旨在研究AUS弹性成像[剪切波（Vs）和F指数]是否能够预测EVs的诊断、严重程度及治疗指征。：2018年4月至2022年10月，我们回顾性收集了194例因CLDs接受弹性成像和EGD检查患者的数据。评估了Vs/F指数值与EVs的存在/严重程度之间的相关性。研究了EVs诊断和治疗指征的每个临界值。：纳入85例无排除标准的患者。有EVs的患者Vs和F指数值显著高于无EVs的患者（分别为P = 0.0005和0.0021），且与EVs的严重程度呈正相关。EVs存在的临界Vs和F指数值分别为1.63 m/s和1.88，敏感性为88.1%/83.3%，特异性为48.8%/51.2%，曲线下面积（AUC）为0.71/0.70。治疗指征的临界Vs和F指数值分别为1.71 m/s和2.08，敏感性为100%/88.2%，特异性为45.6%/52.9%，AUC为0.69/0.70。两种检查方法之间无显著差异。：弹性成像可提供客观评估，因此可能成为EVs诊断和治疗指征的一种非侵入性筛查工具。
