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

Znanstveni rad - Izvorni znanstveni rad

• Autor: Ivica Grgurević
• Autor: Tomislav Bokun
• Autor: Sanda Mustapić
• Autor: Vladimir Trkulja
• Autor: Renata Heinzl
• Autor: Marko Banić
• Autor: Željko Puljiz
• Autor: Boris Lukšić
• Autor: Milan Kujundžić
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti

Sažetak (engleski)

AIM: Primary: 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: to evaluate ability of these measures to discriminate between cirrhotic patients with/without esophageal varices (EV). ----- METHODS: 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. ----- RESULTS: 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. ----- CONCLUSION: 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.

• Ključne riječi (engleski): Adult; Aged; Cohort Studies; Computer Systems; Cross-Sectional Studies; Elasticity Imaging Techniques / methods; Esophageal and Gastric Varices / diagnostic imaging; Esophageal and Gastric Varices / etiology; Female; Humans; Liver / diagnostic imaging; Liver / pathology; Liver Cirrhosis / complications; Liver Cirrhosis / diagnostic imaging; Male; Middle Aged; Prognosis; Retrospective Studies; Spleen / diagnostic imaging; Spleen / pathology
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Izvorni znanstveni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Croatian Medical Journal
• Brojčani podaci: vol. 56, br. 5, str. 470-481
• p-ISSN: 0353-9504
• DOI: https://doi.org/10.3325/cmj.2015.56.470
• URN:NBN: urn:nbn:hr:105:576806
• Datum objave publikacije: 2015-10
• URL dokumenta: https://doi.org/10.3325/cmj.2015.56.470
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-03-28 08:27:33