| Objective: The purpose of this study is to explore whether spleen stiffness can distinguish mild from moderate to severe esophageal and gastric varices in patients with liver cirrhosis,so as to provide help for the diagnosis and treatment of clinicians.Methods: From October 2017 to December 2019,patients with liver cirrhosis were selected for ultrasound elastography of liver and spleen.According to the results of gastroscope,they were divided into moderate and severe esophageal varices group and no or mild esophageal varices group.The relationship between liver stiffness,spleen stiffness,portal vein dilatation,spleen thickness and esophageal varices in patients with cirrhosis was analyzed.The diagnostic performance of spleen stiffness was evaluated by sensitivity(SE),specificity(SP),positive predictive value(PPV),negative predictive value(NPV),accuracy and receiver operating characteristic curve.The cut-off value of splenic stiffness was obtained.Results: There were statistically significant differences in white blood cell count,hemoglobin,platelet count,albumin,total bilirubin,platelet count/spleen diameter,spleen stiffness,Child-Pugh score,spleen thickness,and the presence of portal vein dilation between the moderate and severe esophagogastric varices group and the non or mild esophagogastric varices group(P<0.05).There was no significant difference in aspartic acid aminotransferase,alanine aminotransferase and liver stiffness between the two groups(P>0.05).The results showed that when the cut-off value of spleen stiffness was 21.95 kpa,sensitivity=0.979,specificity=0.453,positive predictive value 0.613,negative predictive value 0.960,diagnostic accuracy 0.7,area under receiver operating characteristic curve AUC=0.74(95% CI: 0.644-0.837,P<0.001).Conclusion: Spleen stiffness is an effective method to distinguish mild and moderate esophageal varices in patients with cirrhosis.This method is non-invasive,safe,easy to promote,and can provide help for clinicians. |
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