Spleen Stiffness Measurement On Real-time Shear Wave Elastography For Noninvasive Assessment Of The Degree Of Esophageal-gastric Varices In HBV-related Cirrhosis

Objective:To investigate the value of spleen stiffness measured by Real-time shear wave elastography(SWE)technique for diagnosing the degree of esophageal-gastric varices in Hepatitis B cirrhosis patients.Methods:A total of 88 cirrhotic patients which were diagnosed in Second hospital of Yinzhou District,Ningbo Hospital from January 2016 to December 2017 and 40 volunteers as control group in gastroenterology department were enrolled.All the patients and volunteers were evaluated for spleen and liver stiffness by SWE and all patients also underwent gastroscopy for the diagnosis of esophageal-gastric varices.According to the results of upper gastrointestinal endoscopy,the patients were divided into four groups,they are no varices group,mild varices group,moderate varices group and severe varices group.Using statistical software analysis the correlation of esophageal-gastric varices with spleen stiffness,liver stiffness and portal vein width.By using gastroscopy as the gold standard,the receiver operating characteristic(ROC)curves of two parameters including spleen stiffness and liver stiffness.The areas under curves(AUC)were used to evaluate the value of two parameters in the diagnosis of moderate and severe esophageal varices.Results:1.There is a significant statistical between the cirrhotic patients group and volunteers group in liver stiffness values and spleen stiffness values,P = 0.000.2.In the 88 th cirrhotic patients,the correlation coefficient between liver stiffness and spleen stiffness is 0.571,p=0.000.3.In the 88 th cirrhotic patients,the correlation coefficient between liver stiffness,spleen stiffness and portal vein width is 0.336、0.484,p<0.05.4.There is with statistical significance among the four varices group in spleen stiffness values,P = 0.000.5.In patients with moderate to serious esophageal varices,the spleen stiffness and liver stiffness values were significantly higher.The ROC curve analysis showed that the AUC of spleen stiffness and liver stiffness in the patients with moderate to serious esophageal varices were 0.901 and 0.878,respectively,the corresponding optimal cut-off values were28.96 kPa and 13.24 kpa.TheAUC,sensitivity and specificity of spleen stiffness were all higher than liver Stiffness.Conclusion:Application of Real-time shear wave elastography(SWE)technique on spleen of cirrhotic patients is a valuable parameter for noninvasive assessment the degree of esophageal-gastric varices.It is especially suitable for cirrhosis patients who can not do gastroscopy,and assist clinical doctors early diagnosis and intervention treatment.