Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen.
OBJECTIVE
To predict esophageal varices in cirrhotic patients with apparent diffusion coefficient (ADC) of the spleen and to correlate the ADC with clinical and laboratory biomarkers of esophageal varices.


METHODS
This study was conducted upon 40 patients (28 male, 12 female; age ranged 19-45 years; mean age = 33 years) with biopsy-proven cirrhotic liver. Twenty age- and sex-matched healthy volunteers were included as a control group. Patients with varices (n = 15) and without varices (n = 25) and volunteers underwent echo-planar diffusion-weighted MR imaging of the abdomen with b factors of 0, 400, and 800 s/mm(2). The ADC maps of the abdomen were reconstructed. The ADC values of the spleen were calculated and correlated with the Child score, platelet count, and prothrombin time.


RESULTS
The mean ADC value of the spleen in cirrhotic patients (1.34 ± 0.05 × 10(-3) mm(2)/s) was significantly different (P = 0.001) from that of volunteers (0.87 ± 0.04 × 10(-3) mm(2)/s). The ADC of the spleen in cirrhotic patients with varices (1.49 ± 0.05 × 10(-3) mm(2)/s) was significantly different (P = 0.001) from that of patients without varices (1.11 ± 0.06 × 10(-3) mm(2)/s). The cut-off ADC value of the spleen used for prediction of cirrhosis and varices was 1.15 and 1.29 × 10(-3) mm(2)/s with areas under the curve were 0.872 and 0.889, respectively. The ADC value of the spleen was correlated with the splenic volume (r = 0.862; P = 0.001), Child score (r = 0.742; P = 0.001), platelet count (r = -0.698; P = 0.01), and prothrombin time (r = 0.684; P = 0.01).


CONCLUSIONS
The ADC value of the spleen can predict esophageal varices in cirrhotic patients and is well correlated with the clinical and laboratory biomarkers of esophageal varices.
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13351, Egypt, arazek@mans.edu.eg.
Ahmed Abdel Khalek Abdel
AA
Razek
Samia Mohammed Ali
SM
Massoud
Mona Ramadan Abdel
MR
Azziz
Mahmoud Mostafa
MM
El-Bendary
Khaled
K
Zalata
Enas Mohamed
EM
Motawea
D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D017352:Echo-Planar Imaging; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology*; D055815:Young Adult