Novel subharmonic-aided pressure estimation for identifying high-risk esophagogastric varices.

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology Pub Date : 2024-10-29 DOI:10.1007/s00535-024-02161-4

Hidekatsu Kuroda, Tamami Abe, Naohisa Kamiyama, Takuma Oguri, Asami Ito, Ippeki Nakaya, Takuya Watanabe, Hiroaki Abe, Kenji Yusa, Yudai Fujiwara, Hiroki Sato, Akiko Suzuki, Kei Endo, Yuichi Yoshida, Takayoshi Oikawa, Keisuke Kakisaka, Kei Sawara, Akio Miyasaka, Takayuki Matsumoto

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Abstract

Background: Subharmonic-aided pressure estimation (SHAPE) is a technique for determining changes in ambient pressure. We aimed to analyze a novel SHAPE integrated into ultrasound diagnostic equipment to predict patients with liver cirrhosis at high risk of esophagogastric varices (EV).

Methods: This prospective study included 111 patients with liver cirrhosis diagnosed between 2020 and 2023. We obtained liver stiffness measurements (LSM) and spleen stiffness measurements (SSM) using shear wave elastography and hepatic vein-portal vein (HV-PV) gradient using the SHAPE method. The EV risk was determined either as null, low, or high by esophagoscopy and Child-Pugh stage.

Results: HV-PV gradient increased concordantly with the increase in EV risk (- 7.0 dB in null-risk, - 4.4 dB in low-risk, and - 2.0 dB in high-risk) with statistically significant difference among any two groups. The most appropriate cut-off value of the HV-PV gradient was - 3.5 dB, and sensitivity, specificity, and positive and negative predictive values were 80.0%, 89.0%, 80.0%, and 88.0%, respectively. The areas under the curve values for predicting the high-risk EV were 0.920, 0.843, and 0.824 for the HV-PV gradient, LSM, and SSM, respectively.

Conclusions: The novel SHAPE system demonstrated high accuracy in identifying patients with liver cirrhosis at a high risk of EV.

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用于识别高风险食管胃静脉曲张的新型次谐波辅助压力估算。

背景：次谐波辅助压力估计（SHAPE）是一种确定环境压力变化的技术。我们旨在分析一种集成到超声诊断设备中的新型 SHAPE，以预测肝硬化患者发生食管胃底静脉曲张（EV）的高风险：这项前瞻性研究纳入了111名在2020年至2023年期间确诊的肝硬化患者。我们使用剪切波弹性成像技术测量了肝脏硬度（LSM）和脾脏硬度（SSM），并使用 SHAPE 方法测量了肝静脉-门静脉（HV-PV）梯度。通过食管镜检查和Child-Pugh分期确定EV风险为无、低或高：结果：HV-PV 梯度随 EV 风险的增加而增加（无 EV 风险为 - 7.0 dB，低 EV 风险为 - 4.4 dB，高 EV 风险为 - 2.0 dB），两组间差异无统计学意义。HV-PV 梯度最合适的临界值为 - 3.5 dB，敏感性、特异性、阳性预测值和阴性预测值分别为 80.0%、89.0%、80.0% 和 88.0%。HV-PV 梯度、LSM 和 SSM 预测高风险 EV 的曲线下面积值分别为 0.920、0.843 和 0.824：新型 SHAPE 系统在识别高危肝硬化患者 EV 方面表现出极高的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.