Noninvasive prediction of high-risk esophageal varices by spleen and liver stiffness measurements using sound touch elastography
10.1016/j.livres.2025.08.002
- Author:
Jinfen WANG
1
;
Siwei TAN
;
Ruiying ZHENG
;
Bilun KE
;
Bin WU
;
Manli WU
Author Information
1. Department of Ultrasound
- Keywords:
High-risk esophageal varices(HREV);
Cirrhosis;
Liver stiffness measurement(LSM);
Spleen stiffness measurement(SSM);
Sound touch elastography(STE);
Prediction models
- From:
Liver Research
2025;9(3):231-238
- CountryChina
- Language:Chinese
-
Abstract:
Background and aims:Noninvasive assessments play a crucial role in ruling out high-risk esophageal varices(HREV)in cirrhotic patients.However,the value of sound touch elastography(STE)in predicting HREV has not been comprehensively investigated.Therefore,this study aimed to establish prediction models based on liver and spleen stiffness measurements obtained by STE and provide assessment strategies and cutoff values tailored for different clinical situations.Methods:This prospective study included cirrhotic patients who underwent esophagogastroduodeno-scopy(EGD).Liver and spleen stiffness measurements by STE were performed within six months of EGD examination.Various prediction models and their corresponding cutoff values were established for different clinical situations,incorporating spleen diameter and laboratory parameters.Results:A total of 154 cirrhotic patients were included in the study and stratified into training(n=119)and validation(n=35)sets.Multivariable analysis revealed platelet,spleen diameter and spleen stiffness measurement as independent predictors of HREV.The model incorporating spleen stiffness measurement,platelet,and spleen diameter demonstrated superior performance in predicting HREV,yielding an area under the receiver operating characteristic curve(AUC)of 0.878 and 0.853 in the training set and validation set,respectively.Application of this model for screening cirrhotic patients could avoid EGDs in 39.7％(27/68)and 35.3％(6/17)of patients in the training and validation sets,respectively.Conclusions:Liver and spleen stiffness measurements obtained through STE are valuable for predicting HREV in cirrhotic patients.The developed prediction models and their corresponding cutoff values provide tailored solutions for various clinical situations,thereby effectively reducing the need for un-necessary endoscopies.
