Role of 2d Shear Wave Elastography for Predicting the Presence of Oesophageal Varices in Patients With Advanced Chronic Liver Disease

Abstract

BACKGROUND: Liver cirrhosis and portal hypertension are common outcomes of chronic liver disease. Portal hypertension leads to development of oesophageal varices (EV). Oesophageal variceal rupture is the most common (1,2,3) dreaded complication of cirrhosis that proves to be fatal. In fact, the severity of liver disease can be correlated by the presence and grade of varices. Currently, oesophagogastroduodenoscopy (OGD) is the gold standard investigation for detection and grading of EV's. However, it is invasive, costly and frequently requires sedation. The aim of this study is to investigate the diagnostic performance of 2D shear wave elastography for predicting the presence of oesophageal varices in patients with advanced chronic liver disease (CLD). METHODS: Study population included 32 cases with CLD and 30 controls without CLD undergoing OGD from August 2019 to August 2021.Prior to undergoing OGD, liver and spleen stiffness elastography were recorded using 2D-SWE. ROC curve was used to nd the cut off values for liver and spleen stiffness for prediction of EV. RESULTS: Using 2D-SWE, the association between liver/ spleen stiffness and presence of EV in CLD cases was found to be statistically signicant (p value-<0.001). The optimal cut off values obtained for prediction of EV was 12 kPa and 12.6kPa for liver and spleen respectively (sensitivity of 81.8% and specicity of 82.5%; PPV-72%, NPV- 89.2%). CONCLUSION: Liver and spleen stiffness values obtained by 2D-SWE were found to be a signicant predictive factor for detection of presence of EV's in patients with CLD.