Endoscopic screening of esophageal varices is recommended in patients with HCV related liver cirrhosis however it may be limited due to economic burden or refused by the patient. Liver stiffness by Fibroscan could be used as method for selection patients at risk of esophageal varices. Aim: To evaluate the efficacy of transient elastography as non-invasive method in diagnosis of esophageal varices in HCV related liver cirrhosis. Patients and Methods: (150) cirrhotic patients (99 males, 51 females) were subjected to upper endoscopy, and platelet count / spleen diameter ratio was calculated for all patients. Results: (Group I) 46 (30.7%) patients with no varices and (Group II) 104 patients with varices, 62 (41.3%) patients with small varices and 42 (28%) patients with large varices. Fibroscan was highly sensitive for prediction of the presence of OVs at cut off value of (20.25 Kpa) as AUROC was (0.777) with sensitivity, specificity, PPV, NPV were (97%, 50%, 81% and 88% respectively) while fibroscan in detection the grades of esophageal varices at cut off (27 Kpa) sensitivity, specificity, PPV, NPV were (67%, 71% 47% and 84% respectively). Platelet count / spleen diameter ratio was more reliable than fibroscan in detection of the grades of OVs as at cut off (620) the AUROC was(0.77); sensitivity,specificity, PPV and NPV were (95%,56%,47%and 97% respectively). Conclusion: Fibroscan could be used as a non-invasive method for diagnosis of esophageal varices however cannot replace upper endoscopy in detection the grades of OVs. But platelet count / spleen diameter ratio was cost-effective and more sensitive than fibroscan in detection of grades of OVs. |
