title: Diagnostic Performance of Shear Wave Elastography for Predicting Esophageal Varices in Patients With Compensated Liver Cirrhosis.
abstract: OBJECTIVE
  The purpose of this study was to investigate the diagnostic performance of shear wave elastography (SWE) for predicting the presence of esophageal varices and high-risk esophageal varices in patients with compensated cirrhosis and to compare it with other nonspecific predictors and according to the presence of splenomegaly.
  
  
  METHODS
  Clinical data from 103 patients with compensated cirrhosis who underwent sonography, SWE, and endoscopy were collected consecutively. Liver stiffness was measured by SWE. Comparisons of the accuracy of prediction between groups were made by areas under the receiver operating characteristic curves (AUROCs), and regression analyses were performed for the multiple variables related to the presence of esophageal varices and high-risk varices.
  
  
  RESULTS
  The optimal cutoff values for predicting the presence of esophageal varices and high-risk varices were 13.9 and 16.1 kPa, respectively. The AUROC of liver stiffness for prediction of esophageal varices was significantly higher than the AUROCs of platelet count, spleen diameter, and platelet count/spleen diameter ratio (P = .025; P = .001; P = .027). For predicting esophageal varices in patients without splenomegaly, the AUROC of liver stiffness was higher than that of the platelet count/spleen diameter ratio. In multivariate logistic regression analysis, liver stiffness and the platelet count/spleen diameter ratio were independent predictors of esophageal varices (P < .001; P = .038). For the presence of high-risk varices, only liver stiffness was a statistically significant independent predictor (P = .012).
  
  
  CONCLUSIONS
  In patients with compensated cirrhosis, liver stiffness measured by SWE is a new effective noninvasive diagnostic tool for predicting the presence of esophageal varices. It is more accurate than the platelet count/spleen diameter ratio, especially in patients without splenomegaly. In addition, the SWE value was the only effective independent factor for predicting high-risk esophageal varices.
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea.
authors.forename: Tae Yoon
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea.
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea ysookim@hanyang.ac.kr.
authors.forename: Yongsoo
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea.
authors.forename: Sanghyeok
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
authors.forename: Woo Kyoung
authors.initials: WK
authors.lastname: Jeong
authors.affiliation: Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000000981:diagnostic imaging*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
keywords: cirrhosis; compensated; esophageal varices; gastrointestinal ultrasound; liver stiffness; shear wave elastography