Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease
Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertensi...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2020-10-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1233-1934 |
| _version_ | 1819266619287797760 |
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| author | Carlos Robles-Medranda Roberto Oleas Miguel Puga-Tejada Manuel Valero Raquel Del Valle Jesenia Ospina Hannah Pitanga-Lukashok |
| author_facet | Carlos Robles-Medranda Roberto Oleas Miguel Puga-Tejada Manuel Valero Raquel Del Valle Jesenia Ospina Hannah Pitanga-Lukashok |
| author_sort | Carlos Robles-Medranda |
| collection | DOAJ |
| description | Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease.
Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %.
Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively.
Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis. |
| first_indexed | 2024-12-23T21:04:09Z |
| format | Article |
| id | doaj.art-ae2b313c471647c3ba37734d3d52afa3 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-23T21:04:09Z |
| publishDate | 2020-10-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-ae2b313c471647c3ba37734d3d52afa32022-12-21T17:31:16ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-10-010811E1623E163210.1055/a-1233-1934Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver diseaseCarlos Robles-Medranda0Roberto Oleas1Miguel Puga-Tejada2Manuel Valero3Raquel Del Valle4Jesenia Ospina5Hannah Pitanga-Lukashok6Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorGastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, EcuadorBackground and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1233-1934 |
| spellingShingle | Carlos Robles-Medranda Roberto Oleas Miguel Puga-Tejada Manuel Valero Raquel Del Valle Jesenia Ospina Hannah Pitanga-Lukashok Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease Endoscopy International Open |
| title | Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| title_full | Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| title_fullStr | Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| title_full_unstemmed | Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| title_short | Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| title_sort | results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1233-1934 |
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