The role of liver stiffness measurement in the evaluation of liver function and esophageal varices in cirrhotic patients.
OBJECTIVE
We aimed to evaluate the efficacy of liver stiffness measurement (LSM) in predicting the presence and severity of esophageal varices (EV) and investigating its association with liver function (LF) in patients with liver cirrhosis.


METHODS
Medical records of 90 cirrhotic patients who underwent LSM by transient elastography were retrospectively reviewed. The relationship between LSM and the presence and severity of EV was evaluated by esophagogastroduodenoscopy (EGD) and multislice spiral computed tomography (MSCT). Another 25 healthy individuals were included as controls.


RESULTS
LSM was significantly associated with the Child-Pugh score in cirrhotic patients, with the highest LSM in those with Child-Pugh C. Patients with clinically decompensated cirrhosis had a higher LSM than those with compensated cirrhosis (36.75 ± 16.54 kPa vs 17.65 ± 10.87 kPa, P < 0.01). However, there was no significant difference in LSM value between patients with severe EV and those with no or non-severe EV determined by endoscopy (28.18 ± 17.44 kPa vs 31.00 ± 18.44 kPa) or MSCT (29.71 ± 18.39 kPa vs 24.90 ± 14.80 kPa). The diagnostic value of LSM for predicting severe EV was low in unselected cirrhotic patients. The presence of EV examined by EGD and MSCT was similar to each other.


CONCLUSIONS
LSM could be used to evaluate the progression of liver cirrhosis continuously. However, its role in assessing EV grades in advanced cirrhosis needs further confirmation. MSCT can assess EV accurately and may serve as an alternative to endoscopy in the assessment of portal hypertension.
Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Jing
J
Hua
Gui Qin
GQ
Liu
Han
H
Bao
Li
L
Sheng
Can Jie
CJ
Guo
Hai
H
Li
Xiong
X
Ma
Jia Lin
JL
Shen
D000328:Adult; D000368:Aged; D018450:Disease Progression; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D059289:Vascular Stiffness / Q000502:physiology*
elasticity imaging techniques; liver cirrhosis; liver stiffness measurement; portal hypertension; varicose veins