Rôle des élasticités splénique et hépatique dans la prédiction des varices oesophagiennes

INTRODUCTION: Non-invasive assessment of portal hypertension in chronic liver disease is a topical subject. AIM: Evaluate accuracy of splenic (SS) and liver (LS) stiffness in predicting the presence of esophageal varices (OV) in chronic hepatitis B patients and determine a non-invasive composite score. METHODS: This was a monocentric cross-sectional study, including carriers of chronic hepatitis B. All patients benefited of SS and LS measurement by impulse elastography (FibroScan Echosens), FIB-4 score calculation and oeso-gastro-duodenal endoscopy. RESULTS: We included 84 patients. The average age was 49.04 ± 12.8 years. The mean value of SS and LS was significantly higher in presence of OV; p=0.000. At respective threshold values of 33.1 KPa and 43KPa, SS was able to predict the presence of OV and large OV with AUROC of 0.795 and 0.906. At respective threshold values of 7.75 KPa and 13.55 KPa, LS was able to predict the presence of OV and large OV with AUROC of 0.836 and 0.894. Arithmetic sum of SS, LS and FIB-4 values was able to predict the presence of OV and large OV with AUROC of 0.918 and 0.942. CONCLUSION: SS and LS are simple and reliable non-invasive tools for predicting OV and large OV. Their association with FIB-4 score improves their diagnostic accuracy.