title: Is the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology predictive of the presence of esophageal varices in patients with cirrhosis of various etiologies?
abstract: OBJECTIVE
  This study's aimwas to determine the accuracy of the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology, to predict the presence of esophageal varices (EVs) in patients with liver cirrhosis of various etiologies.
  
  
  METHODS
  Of the 366 enrolled patients, 192 had hepatitis B virus, 74 had hepatitis C virus, and 100 had alcohol-related cirrhosis. All patients underwent biochemical tests, gastrointestinal endoscopy, and liver and spleen elastography by ARFI. We evaluated the correlation between the presence of EVs and factors including liver and spleen stiffness measured by ARFI, biochemical tests, and other noninvasive measurements, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count (PLT), spleen diameter (SD), PLT to SD ratio, AST to ALT ratio (AAR) score, the AST to PLT ratio index (APRI) score.
  
  
  RESULTS
  A univariate analysis revealed that the AAR score, APRI score, PLT, PLT/SD ratio, and spleen elastography variables were all independently associated with EVs (p<0.05). On multivariate analysis, only spleen elastography was associated with EVs (p=0.001). However, in cases of alcohol-induced liver cirrhosis, spleen stiffness was not reliable for the prediction of EVs.
  
  
  CONCLUSIONS
  Spleen elastography measured using ARFI may serve as a non-invasive method for determining the presence of EVs. However, it is not an appropriate predictor for EVs in alcoholic cirrhosis.
authors.affiliation: Department of Radiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Jaehyung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Radiology, Dong-A University Hospital, Busan, South Korea. risual@dau.ac.kr.
authors.forename: Heejin
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Jinhan
authors.initials: J
authors.lastname: Cho
authors.affiliation: Department of Radiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Jongyoung
authors.initials: J
authors.lastname: Oh
authors.affiliation: Department of Radiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Sangyun
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Dong-A University Hospital, Busan, South Korea.
authors.forename: Sangyoung
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Dong-A University Hospital, Busan, South Korea.
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Dong-A University Hospital, Busan, South Korea.
authors.forename: Yanghyun
authors.initials: Y
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000503:physiopathology*