Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis.
OBJECTIVE
Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with hepatic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters.


METHODS
Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogastroduodenoscopy.


RESULTS
Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical significance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) >/= 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa.


CONCLUSIONS
Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. E-mail:abintintan@yahoo.com.
Adriana
A
Bintintan
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Romeo Ioan
RI
Chira
1st Surgical Department, Emergency Clinical County Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Vasile Virgil
VV
Bintintan
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Georgiana Anca
GA
Nagy
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Maria Roberta
MR
Manzat-Saplacan
Medical Imaging Department, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Monica
M
Lupsor-Platon
Hepatology Department, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Horia
H
Stefanescu
Radiology Department, Emergency Clinical County Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Maria Magdalena
MM
Duma
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Simona Doina
SD
Valean
1st Medical Clinic, Gastroenterology Department, Emergency Clinical County Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Petru Adrian
PA
Mircea
D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D018608:Ultrasonography, Doppler / Q000379:methods*