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Preliminary Study on the Diagnostic Value of Ultrasonic Shear Wave Dispersion for High-risk Esophageal Gastric Varices in Cirrhosis

Wang, J.; Zhou, H.; Li, T.; Liu, C.; Zhao, L.; Xu, B.; Yin, W.; Wang, F.; Liang, J.; Jing, X.; Xiang, H.

2022-11-14 gastroenterology
10.1101/2022.11.11.22282074 medRxiv
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ObjectiveTo explore the clinical value of two-dimensional ultrasonic shear wave elastography (SWE) and shear wave dispersion (SWD) in the diagnosis of high-risk esophageal gastric varices with cirrhosis. MethodsA total of 123 people were included, which were divided into the high-risk esophageal gastric varices (high-risk EGV) group (n =60) and low-risk esophageal gastric varices (low-risk EGV) group (n =63). Both shear wave elastography (SWE) and SWD were adopted to examine each patients liver synchronously with the Doppler ultrasonic instrument. ResultsIn total patients, the results of SWD and SWE of the high-risk EGV group were significantly higher than low-risk EGV group respectively. According to SWD examination, the area under the curve (AUC) of high-risk EGV was 0.709(95%CI:0.616-0.802), the optimal cutoff value was 14.35 m/s/kHz, the sensitivity and specificity was 81.7% and 57.1%, the AUC of high-risk EGV in patients with compensated cirrhosis was 0.786(95%CI:0.656-0.916), the optimal cutoff value was 14.35 m/s/kHz, the sensitivity and specificity was 86.4% and 61.1%, while the AUC of high-risk EGV in patients with decompensated cirrhosis was 0.637(95%CI: 0.494-0.780). According to SWE, the AUC of high-risk EGV in all patients, patients with compensated cirrhosis, and patients with decompensated cirrhosis was 0.606(95%CI: 0.506-0.706), 0.596(95%CI: 0.449-0.743), and 0.579(95%CI: 0.434-0.725), respectively, indicating limited diagnostic value. ConclusionSWD predicted the existence of high-risk EGV in patients with compensated cirrhosis non-invasively and provided a supplementary method to determine whether high-risk EGV exists or not in patients, while SWE had limited diagnostic value.

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