Spleen Stiffness Measurement On Acoustic Radiation Force Impulse For Noninvasive Assessment Of The Degree Of Esophageal Varices And The Risk Of Bleeding In HBV-related Cirrhosis

Objective: 1.Apply the Acoustic Radiation Force Impulse(ARFI)technique on normal adults’ spleen to characterise the spleen stiffness.2.Apply the Acoustic Radiation Force Impulse(ARFI)technique on the spleen of Hepatitis B cirrhosis patients to predict the esophageal varices and the degree of esophageal varices.3.Apply the Acoustic Radiation Force Impulse(ARFI)technique on the spleen of Hepatitis B cirrhosis patients to predict the esophageal varices bleeding.Methods: Form March 2015 to December 2015,the volunteers and the Hepatitis B cirrhosis patients in the first affiliated hospital of nan chang university digestive internal medicine were enrolled,recording gender,age,height,weight,Body Mass Index(BMI)and the results of upper gastrointestinal endoscopy.According to the results of upper gastrointestinal endoscopy,we divided into no varices group,mild varices group,moderate varices group,severe varices group,no varicose bleeding group and varicose bleeding group.Apply the Acoustic Radiation Force Impulse(ARFI)technique on the spleen of normal adult volunteers and Hepatitis B cirrhosis patients,recording the results of spleen stiffness(SWV,m/s).Application of statistical software analysis the correlation of spleen stiffness with gender,age,weight,Body Mass Index(BMI).We respectively drew the receiver operating characteristic curves of the spleen stiffness,and then calculated the area under the receiver operating characteristic curves,and evaluated their predictive value of esophageal varices and esophageal varices bleeding.Results: 1.In the 75 th normal volunteers,the correlation coefficient between gender,age,height,weight,Body Mass Index(BMI)and spleen stiffness are-0.12,、0.02、0.10、0.05、-0.21,P > 0.05,no statistical significance.And there is no statistical significance between the cranial,intermediate and caudal,P > 0.05.2.There is with statistical significance between the Hepatitis B cirrhosis patients’ spleen stiffness and normal adults’,P < 0.001.3.There is with statistical significance between the esophageal varices group’s spleen stiffness and no esophageal varices group’s,P < 0.001.And the area under the receiver operating characteristic curve of the spleen stiffness predicting esophageal varices group were 0.961,respectively.The cut-off value was 2.82 m/s,withing a sensitivity of 90.6%,a specificity of 95.0%.And There is with statistical significance between the different degrees esophageal varices group’s spleen stiffness,P < 0.001.4.There is with statistical significance between the esophageal varices bleeding group’s spleen stiffness and no esophageal varices bleeding group’s,P < 0.001.And the area under the receiver operating characteristic curve of the spleen stiffness predicting esophageal varices bleeding group were 0.952,respectively.The cut-off value was 3.42 m/s,withing a sensitivity of 100%,a specificity of 76.9%.Conclusion: 1.In normal adults,there is no correlation between gender,age,height,weight,Body Mass Index(BMI)and spleen stiffness.2.Application of Acoustic Radiation Force Impulse(ARFI)technique on spleen of Hepatitis B cirrhosis patients can predict the esophageal varices,and has a good predictive accuracy,and can noninvasive evaluate the degree of esophageal varices.3.Application of Acoustic Radiation Force Impulse(ARFI)technique on spleen of Hepatitis B cirrhosis patients can predict the esophageal varices bleeding,and has a good predictive accuracy.