Study On The Correlation Between Degree Of Esophageal Varices In Cirrhosis And Stiffness Of Liver And Spleen And Hemodynamics

Objective:The real-time shear wave elastography(SWE)technology was used to measure liver stiffness(LS)and spleen stiffness(SS).Meanwhile,portal velocity,hepatic artery velocity,and splenic vein velocity were obtained.And compared with the results of gastroscopy,to analyze the correlation between each indicator and the degree of esophageal varices,and to explore the clinical application of each indicator in the evaluation of the degree of esophageal varices in cirrhosis.Methods: We selected 86 patients with cirrhosis as the case group,who were hospitalized in the Department of Gastroenterology of the Second Hospital of Hebei Medical University between December 2018 and December 2019,while 16 patients without esophageal varices served as control group.The SuPerSonic AixPlorer color Doppler ultrasound instrument was used to measure liver and spleen stiffness and hemodynamic indicators,and recorded all basic information such as gender,age,height and weight,as well as liver and spleen stiffness,portal velocity,hepatic artery velocity,splenic vein velocity,and compared with gastroscopy results,and the correlation between each index and the degree of esophageal varices was analyzed,and the ROC curve was drawn to determine the correlation and cut-off value of each index according to the area under the curve.Results:1.The liver and spleen stiffness of the cirrhosis varices group were higher than those of the cirrhosis-free varices group.2.The difference in liver and spleen stiffness between the varices group and the non-varices group was statistically significant.3.Significant differences in liver and spleen stiffness among the varices group among mild,moderate and severe groups.4.Liver stiffness predicts a cut-off value of 13.85 kPa for severe esophageal varices,an AUC of 0.920,a sensitivity of 85.7%,and a specificity of 100%.When the spleen stiffness predicts severe esophageal varices,the cut-off value is 26.32 kPa,the AUC is 0.946,the sensitivity is 82.1%,and the specificity is 92.9%.5.The hemodynamic parameters of different varices groups were not statistically significant.Conclusions:Real-time shear wave elastography measuring liver and spleen stiffness,can assess the degree of esophageal varices.Using cut-off value to predict the risk of severe varices indicates that the risk of rupture is important for clinical decision-making.