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Liver and spleen stiffness measurements based on acoustic radiation force impulse elastography for noninvasive assessment of esophageal varices in hcv- related advanced fibrosis / Ahmed Qaid Ali Albuhairi ; Supervised Mohamed Salah Abdelbary , Samar Kamal Darweesh , Ahmad Mohamed Khairy

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Ahmed Qaid Ali Albuhairi , 2015Description: 135 P. : charts , facsimiles ; 25cmOther title:
  • استخدام جهاز قياس المرونة المعتمد على قوة اندفاع الإشعاع الصوتي لقياس صلابة الكبد و الطحال كتقييم لدوالي المريء عند مرضى تليف الكبد المتقدم بفيروس سي [Added title page title]
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Dissertation note: Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine Summary: BACKGROUND: Upper gastrointestinal endoscopy (UGIE) screening for esophageal varices (EV) is expensive for the health system and invasive for the patients. Aim: To identify the reliability of liver stiffness (LS) and spleen stiffness (SS) as noninvasive predictors of EV, and to compare them with other noninvasive parameters. METHODS: Two hundred patients with HCV-related advanced fibrosis including liver cirrhosis were subjected to: Demographic, clinical, laboratory tests, abdominal ultrasound and Doppler, FIB-4 score, LOK index, platelets to spleen diameter ratio (PSR), LS measured by FibroScan®, LS and SS measured by acoustic radiation force impulse (ARFI) and finally UGIE. RESULTS: Of the 200 patients (Mean age 54.9±8 years; Male 55.5%; CTP class A 72%; Fibrosis stage[F3] 4.5%), 90 patients had EV. For prediction of EV, spleen longitudinal diameter (SD) and splenic vein diameter (SVD) were the best parameters among all the ultrasonographic parameters. PSR, LOK index and FIB- 4 score showed good diagnostic performance. Also, SS and LS showed good diagnostic performance, However, SS had diagnostic performance better than LS (AUROC: 0.760 and 0.70, 95% CI 0.69-0.83 and 0.63-0.77, respectively). The AUROC increased when LS and/or SS was combined with SD, SVD, PSR or FIB- 4 score in a simple prediction model. The prediction model (SD{u00D7}SVD{u00D7}SS) showed the best diagnostic performance (AUROC: 0.85, 95% CI: 0.79-0.90). Followed by prediction model (LS{u00D7}SS/PSR) (AUROC: 0.83, 95% CI: 0.77-0.88). CONCLUSION: LS and SS are reliable predictive tools to presence of EV. Combination of LS and/ or SS with other parameters showed better diagnostic performance than LS or SS alone. These results could be used to reduce the need for routine upper gastrointestinal endoscopy screening
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Item type Current library Home library Call number Copy number Status Date due Barcode
Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.33.M.Sc.2015.Ah.L (Browse shelf(Opens below)) Not for loan 01010110070061000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.33.M.Sc.2015.Ah.L (Browse shelf(Opens below)) 70061.CD Not for loan 01020110070061000

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

BACKGROUND: Upper gastrointestinal endoscopy (UGIE) screening for esophageal varices (EV) is expensive for the health system and invasive for the patients. Aim: To identify the reliability of liver stiffness (LS) and spleen stiffness (SS) as noninvasive predictors of EV, and to compare them with other noninvasive parameters. METHODS: Two hundred patients with HCV-related advanced fibrosis including liver cirrhosis were subjected to: Demographic, clinical, laboratory tests, abdominal ultrasound and Doppler, FIB-4 score, LOK index, platelets to spleen diameter ratio (PSR), LS measured by FibroScan®, LS and SS measured by acoustic radiation force impulse (ARFI) and finally UGIE. RESULTS: Of the 200 patients (Mean age 54.9±8 years; Male 55.5%; CTP class A 72%; Fibrosis stage[F3] 4.5%), 90 patients had EV. For prediction of EV, spleen longitudinal diameter (SD) and splenic vein diameter (SVD) were the best parameters among all the ultrasonographic parameters. PSR, LOK index and FIB- 4 score showed good diagnostic performance. Also, SS and LS showed good diagnostic performance, However, SS had diagnostic performance better than LS (AUROC: 0.760 and 0.70, 95% CI 0.69-0.83 and 0.63-0.77, respectively). The AUROC increased when LS and/or SS was combined with SD, SVD, PSR or FIB- 4 score in a simple prediction model. The prediction model (SD{u00D7}SVD{u00D7}SS) showed the best diagnostic performance (AUROC: 0.85, 95% CI: 0.79-0.90). Followed by prediction model (LS{u00D7}SS/PSR) (AUROC: 0.83, 95% CI: 0.77-0.88). CONCLUSION: LS and SS are reliable predictive tools to presence of EV. Combination of LS and/ or SS with other parameters showed better diagnostic performance than LS or SS alone. These results could be used to reduce the need for routine upper gastrointestinal endoscopy screening

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