Noninvasive Diagnosis of Large Esophageal Varices by Fibroscan: Strong Influence of the Cirrhosis Etiology

Nguyen‐Khac, Eric; Saint-Leger, Pierre; Tramier, B.; Coevoet, Hugues; Capron, Dominique; Dupas, Jean‐Louis

doi:10.1111/j.1530-0277.2010.01191.x

Cited by 62 publications

(56 citation statements)

References 40 publications

(80 reference statements)

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“…The sensitivity of elastography for the presence of EV has been high in the majority of the studies we have reviewed (76-95%) but their corresponding specificity (43-78%) was significantly lower than the value we obtained [9,[21][22][23][24][25][26]. One explanation for this discordance may come from the fact that the reviewed studies were conducted on a population with a heterogenous ethiology of cirrhosis.…”

Section: Disscusionscontrasting

confidence: 46%

Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

Bințințan

Chira

Bințințan³

et al. 2015

Med Ultrason

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Aims: Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with hepatic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters. Material and methods: Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogastroduodenoscopy. Results: Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical significance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) ≥ 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa. Conclusions: Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.

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Section: Disscusionscontrasting

confidence: 46%

Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

Bințințan

Chira

Bințințan³

et al. 2015

Med Ultrason

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“…A further two articles, by Rosenberg et al 121 and Melin et al, 122 were not identified by the electronic searches because they were not appropriately indexed in the electronic databases; they were supplied by the relevant manufacturers together with an unpublished paper by Parkes et al 57 One hundred and ninety-eight citations were excluded at the full-text stage, leaving 17 articles that were included in the review (Figure 4). These 17 articles related to 14 studies: one study of the ELF test, 57,121 four studies of FibroTest, 13,[123][124][125][126] eight studies of FibroScan 97,117,118,122,[127][128][129][130][131] and one study which used both FibroTest and FibroScan. 132 No studies of FibroMAX were identified.…”

Section: Quantity and Quality Of Research Availablementioning

confidence: 99%

“…A further three studies 97,129,130 evaluated the diagnostic test accuracy of FibroScan in patients with liver disease of mixed aetiology, including ALD. Bureau et al 129 studied the ability of FibroScan to predict significant PHt in patients undergoing transjugular liver biopsy for clinical reasons.…”

Section: Fibroscanmentioning

confidence: 99%

“…Bureau et al 129 studied the ability of FibroScan to predict significant PHt in patients undergoing transjugular liver biopsy for clinical reasons. Lemoine et al 97 and Nguyen-Khac et al 130 both specifically recruited patients with cirrhosis. Lemoine et al 97 assessed the ability of FibroScan relative to HVPG measurement to predict significant PHt in patients with compensated cirrhosis, whereas Nguyen-Khac et al 130 assessed its ability relative to upper intestinal endoscopy to predict the presence of large oesophageal varices in patients with cirrhosis of unspecified severity.…”

Section: Fibroscanmentioning

confidence: 99%

See 1 more Smart Citation

Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation

Stevenson

Lloyd-Jones²,

Morgan³

et al. 2012

Health Technol Assess

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTANon-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme ...

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“…In the same study, for a cut-off value of 50.7 kPa, LS had 82.7% PPV and 53.6% NPV (AUROC=0.730) for predicting esophageal bleeding. Published studies [60,61] showed that cut-off values for predicting the presence of large EV are significantly higher in patients with alcoholic as compared with those with viral etiology of chronic liver disease. A meta-analysis which included 18 studies, with more than 3,500 patients [62], showed that TE had 0.90 summary senisitivity with 0.79 summary specificity (AUROC=0.93) for detecting the presence of clinically significant portal hypertension (HVPG≥10 mmHg), 0.87 summary sensitivity with 0.53 summary specificity (AUROC=0.84) for predicting the presence of EV and 0.86 summary sensitivity and 0.59 summary specificity (AUROC=0.78) for detecting large EV.…”

Section: Te For Predicting Liver Cirrhosis Complicationsmentioning

confidence: 99%

Romanian national guidelines and practical recommendations on liver elastography

et al. 2014

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The use of liver elastography has substantially developed in the past few years; the introduction of novel elastographic methods (Transient Elastography, point Shear Wave Elastography, Real Time Shear Wave Elastography, Strain Elastography) has changed the perspective in the evaluation of liver disease. The ongoing research in this area is mainly focused on diffuse liver diseases and for predicting liver cirrhosis complication. This guideline created under the auspice of Romanian Society of Ultrasound in Medicine and Biology is intended to accustomize the clinician with the current practical use of liver elastography and has been issued to help in maximizing the clinical benefit for the patients with chronic liver diseases.

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Noninvasive Diagnosis of Large Esophageal Varices by Fibroscan: Strong Influence of the Cirrhosis Etiology

Abstract: Etiology of cirrhosis has strong impact on LS cutoff for diagnosis of LOV. Studies should be performed with homogenous cirrhosis etiology.

Cited by 62 publications

References 40 publications

Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation

Romanian national guidelines and practical recommendations on liver elastography

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