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Real-time two-dimensional shear wave ultrasound elastography of the liver is a reliable predictor of clinical outcomes and the presence of esophageal varices in patients with compensated liver cirrhosis (CROSBI ID 240771)

Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija

Grgurević, Ivica ; Bokun, Tomislav ; Mustapić, Sanda ; Trkulja, Vladimir ; Heinzl, Renata ; Banić, Marko ; Puljiz, Željko ; Lukšić, Boris ; Kujundžić, Milan Real-time two-dimensional shear wave ultrasound elastography of the liver is a reliable predictor of clinical outcomes and the presence of esophageal varices in patients with compensated liver cirrhosis // Croatian medical journal, 56 (2015), 5; 470-481. doi: 10.3325/cmj.2015.56.470

Podaci o odgovornosti

Grgurević, Ivica ; Bokun, Tomislav ; Mustapić, Sanda ; Trkulja, Vladimir ; Heinzl, Renata ; Banić, Marko ; Puljiz, Željko ; Lukšić, Boris ; Kujundžić, Milan

engleski

Real-time two-dimensional shear wave ultrasound elastography of the liver is a reliable predictor of clinical outcomes and the presence of esophageal varices in patients with compensated liver cirrhosis

Primary aim was to evaluate predictivity of liver stiffness (LS), spleen stiffness (SS), and their ratio assessed by real-time 2D shear wave elastography (RT-2D-SWE) for adverse outcomes (hepatic decompensation, hepatocellular carcinoma or death ; "event") in compensated liver cirrhosis (LC) patients. Secondary aim was to evaluate ability of these measures to discriminate between cirrhotic patients with/without esophageal varices (EV). Predictivity of LS, SS, and LS/SS was assessed in a retrospectively analyzed cohort of compensated LC patients (follow-up cohort) and through comparison with incident patients with decompensated cirrhosis (DC) (cross-sectional cohort). Both cohorts were used to evaluate diagnostic properties regarding EV. In the follow-up cohort (n=44) 18 patients (40.9%) experienced an "event" over a median period of 28 months. LS≥21.5 kPa at baseline was independently associated with 3.4-fold (95% confidence interval [CI] 1.16-10.4, P=0.026) higher risk of event. Association between SS and outcomes was weaker (P=0.056), while there was no association between LS/SS ratio and outcomes. Patients with DC (n=43) had higher LS (35.3 vs 18.3 kPa, adjusted difference 65%, 95% CI 43%-90% ; P<0.001) than compensated patients at baseline. Adjusted odds of EV increased by 13% (95% CI 7.0%-20.0% ; Plt ; 0.001) with 1 kPa increase in LS. At cut-offs of 19.7 and 30.3 kPa, LS and SS had 90% and 86.6% negative predictive value, respectively, to exclude EV in compensated patients. This is the first evaluation of RT-2D-SWE as a prognostic tool in LC. Although preliminary and gathered in a limited sample, our data emphasize the potential of LS to be a reliable predictor of clinical outcomes and the presence of EV in LC patients.

shear wave ultrasound elastography ; esophageal varices ; liver cirrhosis

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Podaci o izdanju

56 (5)

2015.

470-481

objavljeno

0353-9504

10.3325/cmj.2015.56.470

Povezanost rada

Kliničke medicinske znanosti

Poveznice
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