Background and Study Aims: Portal hypertension is one of the most important complications of
liver cirrhosis. The prevalence of varices among cirrhotic patients is variable. Therefore,
endoscopic screening of all patients with liver cirrhosis would result in a large number of
unnecessary additional burdens to endoscopic units. Our aim was to assess the diagnostic
accuracy of spleen stiffness measured by transient elastography (Fibroscan) for prediction of the
presence of varices in patients with hepatitis C related cirrhosis.
Patients and Methods: The study was carried out on 100 patients with HCV-induced cirrhosis and
were divided into 2 groups according to presence or absence of varices by Esophago-gastroduodenoscopy:
Group I: patients with HCV-induced cirrhosis with varices; Group II: patients with
HCV-induced cirrhosis without varices. Clinical and laboratory parameters, andominalultrasonography, Upper gastrointestinal endoscopy and transient elastography to assess the liver
and spleen stiffness were carried out to all studied persons.
Results: Spleen stiffness had significant diagnostic value to differentiate between cirrhotic patients
with varices and cirrhotic patients without varices , it had significant diagnostic value in presence of
esophageal varices at cut-off (≥46.4 K Pascal) the sensitivity for detection of esophageal varices
was 93%, specificity 100%, positive predictive value (PPV) was 80%, negative predictive value
(NPV) was 100%; accuracy was 95% and area under the curve was 0.98 denoting that spleen
stiffness is a good predictor of esophageal varices.
Conclusion: Spleen stiffness was considered as an excellent predictor of esophageal varices and
better than liver stiffness in prediction of esophageal varices presence and had significant
diagnostic value to differentiate between the patients with varices and patients without varices at
cut off (≥46.4 K Pascal) and it may have a role in variceal grading. |
