Our experience with liver and spleen elastography in the prediction of oesophageal varices

Background: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive. Objectives: This study a...

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Main Authors: Shivali Arya, Rashmi Dixit, Sneha Harish C, Anjali Prakash, Amarender S. Puri
Format: Article
Language:English
Published: AOSIS 2024-01-01
Series:South African Journal of Radiology
Subjects:
Online Access:https://sajr.org.za/index.php/sajr/article/view/2724
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author Shivali Arya
Rashmi Dixit
Sneha Harish C
Anjali Prakash
Amarender S. Puri
author_facet Shivali Arya
Rashmi Dixit
Sneha Harish C
Anjali Prakash
Amarender S. Puri
author_sort Shivali Arya
collection DOAJ
description Background: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive. Objectives: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. Method: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups. Results: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p  0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p  0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p  0.05). Conclusion: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs. Contribution: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV.
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spelling doaj.art-fa4ed6d6867343df90797eedcab0c2072024-02-01T12:50:16ZengAOSISSouth African Journal of Radiology1027-202X2078-67782024-01-01281e1e710.4102/sajr.v28i1.27241245Our experience with liver and spleen elastography in the prediction of oesophageal varicesShivali Arya0Rashmi Dixit1Sneha Harish C2Anjali Prakash3Amarender S. Puri4Department of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi Department of Radiodiagnosis, Government Medical College, ChandigarhDepartment of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New DelhiDepartment of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New DelhiDepartment of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New DelhiDepartment of Gastroenterology, Govind Ballabh Pant Hospital, New DelhiBackground: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive. Objectives: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. Method: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups. Results: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p  0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p  0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p  0.05). Conclusion: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs. Contribution: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV.https://sajr.org.za/index.php/sajr/article/view/2724oesophageal varicesacoustic radiation force imagingchronic liver diseaseshear wave velocitysplenic stiffnesshepatic stiffness
spellingShingle Shivali Arya
Rashmi Dixit
Sneha Harish C
Anjali Prakash
Amarender S. Puri
Our experience with liver and spleen elastography in the prediction of oesophageal varices
South African Journal of Radiology
oesophageal varices
acoustic radiation force imaging
chronic liver disease
shear wave velocity
splenic stiffness
hepatic stiffness
title Our experience with liver and spleen elastography in the prediction of oesophageal varices
title_full Our experience with liver and spleen elastography in the prediction of oesophageal varices
title_fullStr Our experience with liver and spleen elastography in the prediction of oesophageal varices
title_full_unstemmed Our experience with liver and spleen elastography in the prediction of oesophageal varices
title_short Our experience with liver and spleen elastography in the prediction of oesophageal varices
title_sort our experience with liver and spleen elastography in the prediction of oesophageal varices
topic oesophageal varices
acoustic radiation force imaging
chronic liver disease
shear wave velocity
splenic stiffness
hepatic stiffness
url https://sajr.org.za/index.php/sajr/article/view/2724
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