title: Predict esophageal varices via routine trans-abdominal ultrasound: A design of classification analysis model.
abstract: OBJECTIVE
  Upper gastrointestinal endoscopy remains the gold standard for diagnosis of esophageal varices. Trans-abdominal ultrasound, as a noninvasive routine examination for the follow-up of cirrhosis patient, is safe, cheap, easy to perform, and plays an important role. In this study, we attempt to design a practical classification analysis model to predict esophageal varices via ultrasound.
  
  
  METHODS
  Compared with endoscopy, the ultrasound qualitative signs (lower esophageal Doppler signals, left gastric vein hepatofugal flow, and paraumbilical vein recanalization) and quantitative parameters (spleen diameter, spleen vein diameter, portal vein diameter, and portal vein velocity) have been evaluated in 286 cirrhosis patients.
  
  
  RESULTS
  The classification analysis model is designed as that: the patients are defined with esophageal varices high risk, who with any ultrasound qualitative signs or who with spleen diameter greater than 162 mm without qualitative parameters. The sensitivity for detecting esophageal varices is 97.5% and the specificity is 82.6%, while the positive predictive value is 96.7%, negative predictive value is 83.4%, and the omission diagnostic rate is 2.5%.
  
  
  CONCLUSIONS
  This classification analysis model design includes ultrasound qualitative signs and spleen diameter, which can be detected easily via routine ultrasound without other auxiliary. The classification analysis model is useful in detecting esophageal varices, which may be a supplement for predicting of esophageal varices, and reducing the frequency of endoscopy in the follow-up of cirrhosis patients.
authors.affiliation: Departments of Ultrasound, The First Affiliated Hospital.
authors.forename: Chao-Xue
authors.initials: CX
authors.lastname: Zhang
authors.affiliation: Departments of Gastroenterology, The First Affiliated Hospital.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Xu
authors.affiliation: Departments of Infectious disease, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Jia-Bin
authors.initials: JB
authors.lastname: Li
authors.affiliation: Departments of Gastroenterology, The First Affiliated Hospital.
authors.forename: De-Run
authors.initials: DR
authors.lastname: Kong
authors.affiliation: Departments of Ultrasound, The First Affiliated Hospital.
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.affiliation: Departments of Gastroenterology, The First Affiliated Hospital.
authors.forename: Xiao-Yong
authors.initials: XY
authors.lastname: Xu
authors.affiliation: Departments of Infectious disease, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Zhao
mesh_terms: D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology; D005500:Follow-Up Studies; D005773:Gastroscopy; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012306:Risk; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
keywords: diagnosis; esophageal varices; portal hypertension; ultrasound