结合二维剪切波弹性成像评估的脾脏直径和 Baveno VI 标准,排除高风险静脉曲张。

IF 0.7 4区 医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Zhilin Zhang, Huihui Zhou, Kunlong Duan, Feifei Chen, Jun Zhang, Lin Sang, Xiansheng Zhu, Ming Yu
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引用次数: 0

摘要

摘要:代偿性晚期慢性肝病(cACLD)患者如果通过瞬态弹性成像符合巴韦诺VI标准,就可以安全地免于食管胃十二指肠镜(EGD)检查。最近,有人提出了通过二维剪切波弹性成像(2D-SWE)评估的 Baveno VI 标准临界值。我们的目的是验证它是否能排除 cACLD 患者的高危静脉曲张(HRVs);将脾脏直径(SPD)与 Baveno VI 标准相结合,并评估它是否能避免更多的 EGD 筛查。我们共纳入了 173 例成功测量肝硬度(LS)并进行了 EGD 检查的 cACLD 患者。我们分析了预测心率变异的风险因素,并比较了不同模型在排除心率变异方面的表现。血小板计数、LS 和 SPD 是心率变异的独立预测因子。血小板计数、LS、脾脏硬度和 SPD 诊断心率变异的 AUC 分别为 0.797、0.757、0.834 和 0.804。通过 2D-SWE 评估的 Baveno VI 标准使 25.4% 的 EGD 筛查免于失败,而漏诊了 2.4% 的 HRV 患者。将 SPD ≤11.1 厘米与巴韦诺Ⅵ标准相结合,可比仅应用巴韦诺Ⅵ标准节省更多的胃肠道造影检查(45.1% 对 25.4%,P < 0.001),但漏诊了 4.9% 的心率变异患者。通过 2D-SWE 评估的 Baveno VI 标准可安全地应用于 cACLD 患者,以排除 HRV 患者。Baveno VI/SPD联合模型可以安全、显著地提高EGD幸免率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combining Spleen Diameter and the Baveno VI Criteria Assessed by 2-Dimensional Shear Wave Elastography to Rule Out High-Risk Varices.

Abstract: Patients with compensated advanced chronic liver disease (cACLD) can safely spared screening esophagogastroduodenoscopy (EGD) when they meet the Baveno VI criteria as assessed by transient elastography. Recently, the cutoff values of the Baveno VI criteria assessed by 2-dimensional shear wave elastography (2D-SWE) were proposed. We aimed to validate it to rule out high-risk varices (HRVs) in cACLD patients; combine spleen diameter (SPD) with the Baveno VI criteria and assess whether it can spare more screening EGD. A total of 173 cACLD patients with successful liver stiffness (LS) measurements and EGD examinations were included. We analyzed the risk factors that predicted HRVs and compared the performances of different models for ruling out HRVs. The platelet count, LS, and SPD were independent predictors of HRVs. The AUCs of platelet count, LS, spleen stiffness and SPD for diagnosing HRVs were 0.797, 0.757, 0.834, and 0.804, respectively. The Baveno VI criteria assessed by 2D-SWE spared 25.4% of EGD screenings and missed 2.4% of the HRV patients. Combining SPD ≤11.1 cm with the Baveno VI criteria could spare more EGD screenings than just applying the Baveno VI criteria (45.1% vs 25.4%, P < 0.001), and missed 4.9% of the HRV patients. The Baveno VI criteria assessed by 2D-SWE could be safely applied in cACLD patients to rule out HRV patients. The combined model Baveno VI/SPD could safely and significantly increase the rate of spared EGD.

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来源期刊
Ultrasound Quarterly
Ultrasound Quarterly RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.50
自引率
7.70%
发文量
105
审稿时长
>12 weeks
期刊介绍: Ultrasound Quarterly provides coverage of the newest, most sophisticated ultrasound techniques as well as in-depth analysis of important developments in this dynamic field. The journal publishes reviews of a wide variety of topics including trans-vaginal ultrasonography, detection of fetal anomalies, color Doppler flow imaging, pediatric ultrasonography, and breast sonography. Official Journal of the Society of Radiologists in Ultrasound
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