Efficacy Of Measurement Of Spleen Stiffness By Acoustic Radiation Force Impulse Imaging For The Identification Of Egyptian Cirrhotic Patients With Esophageal Varices

Abstract

The development of OV varices as a consequence of portal hypertension is a common and dangerous complication in patients with liver cirrhosis. Current guidelines recommend screening all cirrhotic patients by endoscopy, to identify patients at risk of bleeding who should undergo prophylactic treatment. However, since the prevalence of oesophegeal varices in cirrhotic patients is variable and increasing by time, universal screening would imply a large number of unnecessary endoscopies and a heavy burden for endoscopy units. In addition, compliance to screening programs may be hampered by the perceived unpleasantness of endoscopy. Predicting the presence and grading of esophageal varices by non-invasive means might increase compliance and would permit to restrict the performance of endoscopy to those patients with a high probability of having varices. Over the years, several studies have addressed this issue. In search of possible non-invasive predictors for esophageal varices, the present study tried to determine the value of ARFI Fibroscan for selecting patients with cirrhosis at risk of bearing large OV and therefore eligible for upper tract endoscopy. All Patients were subjected to full history taking, full clinical examination, laboratory investigations, abdominal ultrasonography, diagnostic upper GIT endoscopy. In this study, We prospectively collected data on 45 consecutive patients referred to THE NATIONAL RESEARCH INSTITUTE , they were divided into 2 groups: -Group (I) includes 30 patients with liver cirrhosis among them 15 patients with varicose viens and 15 patients with no varicose , Group (II) includes 15 healthy persons with no liver cirrhosis nor varicose viens taken as a control group. We found positive correlation and significance between liver stiffness and AST, ALT, creatinine and spleen size, while platelets significant and negative correlation. Also, spleen stiffness positive and significant correlation between creatinine, INR, s. bilirubin, liver size and spleen size, while platelets negative and significant correlation.