Shear wave elastography combined with conventional ultrasonography in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma
10.3760/cma.j.issn.1004-4477.2018.01.011
- VernacularTitle:剪切波弹性成像联合常规超声诊断乙肝相关性肝细胞癌患者食管胃静脉曲张
- Author:
Zhiheng CHEN
1
;
Yi QIAN
;
Haibin TU
;
Jia GUO
Author Information
1. 200438,上海东方肝胆外科医院超声科
- Keywords:
Ultrasonography;
Esophageal and gastric varices;
Hepatitis B;
chronic;
Carcinoma;
hepatocellular;
Elasticity imaging techniques
- From:
Chinese Journal of Ultrasonography
2018;27(1):43-48
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of shear wave elastography(SWE) in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma(HCC). Methods From October 2016 to May 2017,a total of 325 patients with hepatitis B-related HCC received conventional ultrasonography and SWE examinations in Shanghai Eastern Hepatobiliary Surgery Hospital were selected. The basic clinical data,conventional ultrasonography,SWE examination parameters and gastroscopy results of 192 patients were successfully collected. The training group ( 120 cases) and the validation group (72 cases) were divided from these patients according to the time order of entering the study.The gastroscopy results were used as the gold standard and the training group were analyzed using univariate and multivariate analysis.A new GOV diagnostic model was established and the diagnosis value of which were validated and evaluated in the validation group. Results Among 9 parameters studied,the maximum flow velocity of the portal vein,the thickness of the spleen and the stiffness of the spleen were independent factors affecting GOV in patients with hepatitis B-related HCC with odds ratio of 0.755(95% CI 0.617-0.924),1.375(95%CI 1.171-1.614) and 1.093(95% CI 1.043 -1.145),respectively(all P < 0.01).T he area under ROC curve of GOV diagnostic model that containd these 3 parameters diagnosing GOV in validation group was 0.914 (95% CI,0.832~0.995).The -1.49 was the best cut-off value with sensitivity,specificity,positive predictive value,negative predivtive value and coincidence rate of 79.0%,92.5%,91.3%,81.5% and 85.8%,respectively. Conclusions The GOV diagnostic model established by combining SWE and conventional ultrasonography is of certain value in diagnosis of GOV in patients with hepatitis B-related HCC yet needs further validation.
