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Non-invasive prediction of oesophageal varices with FibroScan and Doppler U/S in HCV patients with cirrhosis

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Tropical Medicine

Advisors

Essmat, Gamal-El-Din , Ramzi, Eiman E. , Hasab-Allah, Maha , Esmaeil, Suhair A.

Authors

Mugahed, Samah Abdel-Hafezh

Accessioned

2017-07-12 06:41:09

Available

2017-07-12 06:41:09

type

M.D. Thesis

Abstract

Introduction: Worldwide, there is a quest for non invasive methods for detection of oesophageal varices in patients with cirrhosis. Fibroscan (TE) is a type of ultrasound machine that designed for painless, rapid and non invasive liver stiffness measurements. Various non invasive indexes of Doppler U/S including PVV, SI, SPI, SAPI, CI and platelet/ spleen size ratio; have been putatively shown to be predictive of the presence of oesophageal varices in patients with cirrhosis.Aim of the work: The aim of this work is to evaluate the value of FibroScan and Doppler U/S as non invasive methods for the prediction of oesophageal varices in HCV Egyptian patients with cirrhosis.Subjects and methods: 133 patients with HCV related cirrhosis were prospectively enrolled from 2011 to 2012. They presented to gastrointestinal endoscopy unit of NHTMRI for upper GIT endoscopy examination for variceal screening. All patients were subjected to; Full lab, Fibroscan, Doppler U/S, upper GIT endoscopy and liver biopsy. Results: The significant finding of this study is that there was a positive correlation between the values of liver stiffness measurements and the presence of oesophageal varices (P value=0.008, AUROC was0.70) and at a cut off 17.4kPa, LSM could predict the presence of oesophageal varices with 84%sensitivity, 56%specificity. The study proposed prediction model and equation with cut level 0.5 using both liver stiffness measurements and Doppler U/S indexes (PVV, SI, SPI and CI) with overall accuracy 92.1%, sensitivity 89.1%, specificity 94.4%, PVV 92.4% and NPV 91.8%Conclusion: Liver stiffness measurements and Doppler indices are non invasive methods that could be able to predict presence and severity of oesophageal varices.

Issued

1 Jan 2014

DOI

http://dx.doi.org/10.21473/iknito-space/36292

Details

Type

Thesis

Created At

28 Jan 2023