The usefulness of transient elastography (Fibroscan(R)) for predicting esophageal varices and esophageal variceal hemorrhage in patients with chronic liver diseases

Lee, Si Hyung; Eun, Jong Ryul; Lee, Heon Ju; Kim, Tae Nyeun; Jang, Byung Ik; Choi, Jae Won; Park, Youn Sun; Kim, Kyung Ok; Lee, Gyu Hyung; Moon, Hee Jung; Lee, Sang Hoon

Abstract

BACKGROUND/AIMS: This study was conducted to evaluate the efficacy of transient elastography (Fibroscan(R)) for predicting esophageal varices and esophageal variceal hemorrhage in patients with chronic liver diseases.
METHODS
We studied 245 patients (mean age: 50.1 years, male/female: 181/64) with chronic liver diseases to determine the relation between the clinical or serologic markers associated with liver fibrosis and tissue elastography, and these tests were performed in Feb 2007. The causes of chronic liver diseases were hepatitis B virus in 139 (56.7%), hepatitis C virus in 30 (12.2%), alcohol in 38 (15.5%), nonalcoholic fatty liver disease in 23 (9.4%), autoimmune liver disease in 3 (1.2%), and unknown 12 (4.9%).
RESULTS
Transient elastography was correlated with APRI (r=0.712) and the grades of esophageal varices (r=0.635). The AUROC values of transient elastography were 0.916 (95% CI: 0.838-0.954) for the presence of esophageal varices, 0.875 (95% CI: 0.819-0.931) for the esophageal varices grade > or =2, and 0.895 (95% CI: 0.846-0.945) for esophageal variceal hemorrhage. The cutoff values for 90% specificity were 15.3 kPa for esophageal varices, 20.7 kPa for esophageal varices grade > or =2 and 34.8 kPa for esophageal variceal hemorrhage, while the negative predictive values were 90%, 94% and 97%, respectively.
CONCLUSIONS
Transient elastography was correlated with the presence of esophageal varices, the grades of esophageal varices and the presence of esophageal variceal hemorrhage. Therefore, this data may help to screen those patients how might undergo upper gastrointestinal endoscopy.