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Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients

Background and Objectives: Portal hypertension (PH), as the main consequence of cirrhosis, leads to the development of gastroesophageal varices (GEVs). Variceal hemorrhage (VH) caused by the rupture of GEVs is a life-threatening emergency. Thus, the prediction of VH risk is considerably important. O...

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Autores principales: Sun, Xiaohui, Zhang, Li, Jiang, Ling, Cui, Ligang, Li, Xiaoguang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776875/
https://www.ncbi.nlm.nih.gov/pubmed/36552916
http://dx.doi.org/10.3390/diagnostics12122909
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author Sun, Xiaohui
Zhang, Li
Jiang, Ling
Cui, Ligang
Li, Xiaoguang
author_facet Sun, Xiaohui
Zhang, Li
Jiang, Ling
Cui, Ligang
Li, Xiaoguang
author_sort Sun, Xiaohui
collection PubMed
description Background and Objectives: Portal hypertension (PH), as the main consequence of cirrhosis, leads to the development of gastroesophageal varices (GEVs). Variceal hemorrhage (VH) caused by the rupture of GEVs is a life-threatening emergency. Thus, the prediction of VH risk is considerably important. Our pilot study aimed to identify the risk factors of variceal hemorrhage (VH) in cirrhosis. Materials and Methods: Cirrhotic patients were prospectively included and divided into two groups according to the presence or absence of VH. Conventional ultrasound and shear wave dispersion (SWD) imaging were conducted to detect the portal vein diameter, spleen diameter, ascites, liver stiffness (LS) and shear wave dispersion slope (SWDS). The laboratory tests were recorded, including platelets (PLT), alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB). The risk factors of VH were screened using univariate analyses and identified using multivariate logistic regression. The ROC curves were used to assess diagnostic accuracy. Comparisons between AUCs were performed using the Delong method. Results: Sixty-five patients with 22 VHs were finally included. The SWDS, spleen diameter and ascites were identified as independent risk factors for VH. The SWDS showed good performance for diagnosing VH (AUC = 0.768, 95% CI: 0.647–0.864), and sensitively identified 95.5% (95% CI: 77.2%–99.9%) of patients with VH. Including the three risk factors in multivariate logistic regression, we obtained a formula for diagnosing VH: −20.749 + 0.804 × SWDS + 0.449 × spleen diameter + 1.803 × ascites (no ascites = 0, ascites = 1). Comparison of AUCs revealed that the formula (AUC = 0.900, 95% CI: 0.800–0.961) performed better than LS, SWDS, and spleen diameter in diagnosing VH (p < 0.001; p < 0.05; p < 0.05). Conclusions: SWDS is a sensitive parameter for assessing the risk of VH. Combining the SWDS, spleen diameter and ascites resulted in good diagnostic accuracy.
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spelling pubmed-97768752022-12-23 Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients Sun, Xiaohui Zhang, Li Jiang, Ling Cui, Ligang Li, Xiaoguang Diagnostics (Basel) Article Background and Objectives: Portal hypertension (PH), as the main consequence of cirrhosis, leads to the development of gastroesophageal varices (GEVs). Variceal hemorrhage (VH) caused by the rupture of GEVs is a life-threatening emergency. Thus, the prediction of VH risk is considerably important. Our pilot study aimed to identify the risk factors of variceal hemorrhage (VH) in cirrhosis. Materials and Methods: Cirrhotic patients were prospectively included and divided into two groups according to the presence or absence of VH. Conventional ultrasound and shear wave dispersion (SWD) imaging were conducted to detect the portal vein diameter, spleen diameter, ascites, liver stiffness (LS) and shear wave dispersion slope (SWDS). The laboratory tests were recorded, including platelets (PLT), alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB). The risk factors of VH were screened using univariate analyses and identified using multivariate logistic regression. The ROC curves were used to assess diagnostic accuracy. Comparisons between AUCs were performed using the Delong method. Results: Sixty-five patients with 22 VHs were finally included. The SWDS, spleen diameter and ascites were identified as independent risk factors for VH. The SWDS showed good performance for diagnosing VH (AUC = 0.768, 95% CI: 0.647–0.864), and sensitively identified 95.5% (95% CI: 77.2%–99.9%) of patients with VH. Including the three risk factors in multivariate logistic regression, we obtained a formula for diagnosing VH: −20.749 + 0.804 × SWDS + 0.449 × spleen diameter + 1.803 × ascites (no ascites = 0, ascites = 1). Comparison of AUCs revealed that the formula (AUC = 0.900, 95% CI: 0.800–0.961) performed better than LS, SWDS, and spleen diameter in diagnosing VH (p < 0.001; p < 0.05; p < 0.05). Conclusions: SWDS is a sensitive parameter for assessing the risk of VH. Combining the SWDS, spleen diameter and ascites resulted in good diagnostic accuracy. MDPI 2022-11-23 /pmc/articles/PMC9776875/ /pubmed/36552916 http://dx.doi.org/10.3390/diagnostics12122909 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sun, Xiaohui
Zhang, Li
Jiang, Ling
Cui, Ligang
Li, Xiaoguang
Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title_full Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title_fullStr Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title_full_unstemmed Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title_short Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients
title_sort shear wave dispersion slope measured with shear wave dispersion imaging is associated with variceal hemorrhage in cirrhotic patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776875/
https://www.ncbi.nlm.nih.gov/pubmed/36552916
http://dx.doi.org/10.3390/diagnostics12122909
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