Value of virtual touch tissue quantification technique in predicting risk of esophageal varices in patients with hepatic cirrhosis

doi:10.3877/cma.j.issn.1672-6448.2018.11.012

Abstract

Abstract:

Obiective

This study discusses the diagnosis efficiency and clinical value of application of two kinds of ultrasonic technology in the risk of EV in hepatic cirrhosis.

Methods

This research selected 154 cases of patients (NEV, n=52 and EV, n=102). The conventional ultrasound examination and VTQ are performed in every patients been checked hepatic portal vein diameter and blood flow velocity, spleen vein diameter and blood flow velocity and the value of SWV of liver and spleen in patients with hepatic sclerosis.

Result

The comparison of clinical datas and liver function classification Child-Pugh grades of liver function of patients in group of EV, The inner diameter of hepatic portal vein and splenic vein and the SWV value of liver and spleen in group of EV were obviously higher than those in group of NEV, with statistical difference (P<0.05); The blood flow velocity of hepatic portal vein and splenic vein in group of EV were lower than that in group of NEV, with statistical difference (P<0.05). The value of SWV of liver and spleen are the independent risk factors in predicted EV, and values of OR were 2.396, 1.007 and 2.396, respectively (P<0.05). The area under the curves (AUC) were 0.88 (95%CI: 0.824 0.936), 0.911 (95%CI: 0.866-0.957) and 0.866 (95%CI: 0.863-0.953); The best cut-off values respectively were 14.05mm, 2.013m/s and 2.937m/s; Sensitivity were respectively 73.6%, 82.4% and 79.6%. Specificity were 87.1%, 90.3% and 87.6% respectively. The accuracy rate were 82.5%, 87.7% and 85.1% respectively.

Conclusion

Diameter of hepatic portal vein, SWV values of liver and spleen were independent risk factors of EV.The ROC curves analysis showed that diameter of hepatic portal vein, SWV values of liver and spleen have good diagnostic performance in assessing the risk of EV.Liver SWV value has a unique advantage.

Key words: Liver cirrhosis, Esophageal varices, Ultrasonography

Dongmei Hu, Hui Wang, Dongyan Yang, Xiaoping Li, Chunxiang Jin. Value of virtual touch tissue quantification technique in predicting risk of esophageal varices in patients with hepatic cirrhosis[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(11): 850-856.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.11.012

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I11/850

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References 36

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组别	例数	年龄（岁，±s）	性别（男/女）	BMI（kg/m²，χ²±s）	Child Pugh分级（A/B/C）	肝门静脉内径（mm，χ²±s）
NEV组	52	53±9	30/22	21±1	48/4/0	13.30±0.84
EV组	102	56±10	65/37	20±2	52/42/8	15.26±1.91
统计值	?	t=0.38	χ²=-0.41	t=-0.31	χ²=50.74	t=1.62
P值	?	0.71	0.68	0.76	0.00	0.02
组别	例数	肝门静脉流速（mm/s，χ²±s）	脾静脉内径（mm，χ²±s）	脾静脉流速（mm/s，χ²±s）	肝脏SWV值（m/s，χ²±s）	脾脏SWV值（m/s，χ²±s）
NEV组	52	158.71±18.92	9.37±1.31	174.89±21.00	1.82±0.15	2.88±0.13
EV组	102	128.06±23.09	11.83±2.29	144.89±33.80	2.28±0.34	3.33±0.31
统计值	?	t=-0.18	t=0.03	t=-0.10	t=3.66	t=3.92
P值	?	0.03	0.05	0.03	0.00	0.00

组别	例数	年龄（岁，±s）	性别（男/女）	BMI（kg/m²，χ²±s）	Child Pugh分级（A/B/C）	肝门静脉内径（mm，χ²±s）
NEV组	52	53±9	30/22	21±1	48/4/0	13.30±0.84
EV组	102	56±10	65/37	20±2	52/42/8	15.26±1.91
统计值	?	t=0.38	χ²=-0.41	t=-0.31	χ²=50.74	t=1.62
P值	?	0.71	0.68	0.76	0.00	0.02
组别	例数	肝门静脉流速（mm/s，χ²±s）	脾静脉内径（mm，χ²±s）	脾静脉流速（mm/s，χ²±s）	肝脏SWV值（m/s，χ²±s）	脾脏SWV值（m/s，χ²±s）
NEV组	52	158.71±18.92	9.37±1.31	174.89±21.00	1.82±0.15	2.88±0.13
EV组	102	128.06±23.09	11.83±2.29	144.89±33.80	2.28±0.34	3.33±0.31
统计值	?	t=-0.18	t=0.03	t=-0.10	t=3.66	t=3.92
P值	?	0.03	0.05	0.03	0.00	0.00

影响因素	β值	S.E	Wald值	OR（95%CI）	P值
年龄（岁)	0.034	0.021	6.582	1.035（0.999~1.073）	0.053
性别（男/女）	-0.254	0.376	0.000	0.776（0.392~1.536）	0.467
BMI（kg/m²）	-0.135	0.145	2.164	0.874（0.683~1.118）	0.284
Child Pugh分级（A/B/C）	2.314	0.522	30.96	10.12（3.464~29.542）	<0.001
右肝斜径（mm）	-0.009	0.117	0.600	0.991（0.970~1.013）	0.420
脾脏厚径（mm）	0.100	0.254	15.23	1.105（1.050~1.163）	<0.001
脾脏长径（mm）	0.015	0.076	4.777	1.015（1.001~1.028）	0.031
肝门静脉内径（mm）	1.652	3.216	29.316	5.215（2.945~9.234）	<0.001
肝门静脉流速（mm/s）	-0.076	0.140	27.11	0.927（0.902~0.953）	<0.001
脾静脉内径（mm）	0.976	2.005	30.67	2.654（1.894~3.721）	<0.001
脾静脉流速（mm/s）	-0.033	0.070	24.72	0.968（0.955~0.981）	<0.001
肝脏SWV值（m/s）	0.008	1.348	30.563	1.008（1.005~1.011）	<0.001
脾脏SWV值（m/s）	0.008	0.935	22.11	1.008（1.005~1.011）	<0.001

影响因素	β值	S.E	Wald值	OR（95%CI）	P值
年龄（岁)	0.034	0.021	6.582	1.035（0.999~1.073）	0.053
性别（男/女）	-0.254	0.376	0.000	0.776（0.392~1.536）	0.467
BMI（kg/m²）	-0.135	0.145	2.164	0.874（0.683~1.118）	0.284
Child Pugh分级（A/B/C）	2.314	0.522	30.96	10.12（3.464~29.542）	<0.001
右肝斜径（mm）	-0.009	0.117	0.600	0.991（0.970~1.013）	0.420
脾脏厚径（mm）	0.100	0.254	15.23	1.105（1.050~1.163）	<0.001
脾脏长径（mm）	0.015	0.076	4.777	1.015（1.001~1.028）	0.031
肝门静脉内径（mm）	1.652	3.216	29.316	5.215（2.945~9.234）	<0.001
肝门静脉流速（mm/s）	-0.076	0.140	27.11	0.927（0.902~0.953）	<0.001
脾静脉内径（mm）	0.976	2.005	30.67	2.654（1.894~3.721）	<0.001
脾静脉流速（mm/s）	-0.033	0.070	24.72	0.968（0.955~0.981）	<0.001
肝脏SWV值（m/s）	0.008	1.348	30.563	1.008（1.005~1.011）	<0.001
脾脏SWV值（m/s）	0.008	0.935	22.11	1.008（1.005~1.011）	<0.001

影响因素	β值	S.E	Wald值	OR（95%CI）	P值
Child Pugh分级（A/B/C）	0.449	1.014	4.917	1.567（1.032~10.142）	0.685
脾脏厚径（mm）	0.060	0.441	0.174	1.062（0.980~1.150）	0.14
脾脏长径（mm）	0.002	0.164	0.107	1.002（0.973~1.032）	0.881
肝门静脉内径（mm）	0.874	3.971	9.519	2.396（1.116~5.141）	0.025
肝门静脉流速（mm/s）	-0.010	0.221	0.992	0.990（0.948~1.033）	0.633
脾静脉内径（mm）	0.562	3.660	7.108	1.754（0.984~3.127）	0.057
脾静脉流速（mm/s）	-0.020	0.102	5.232	0.980（0.960~1.002）	0.069
肝脏SWV值（m/s）	0.007	1.851	4.333	1.007（1.003~1.011）	<0.001
脾脏SWV值（m/s）	0.005	1.664	0.106	1.005（1.002~1.009）	0.002

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