Ultrasound and point shear-wave elastography assessment for predicting esophageal varices in schistosomiasis-associated non-cirrhotic portal hypertension
Prospective cross-sectional study demonstrates splenic elastography predicts esophageal varices in schistosomiasis-related portal hypertension, suggesting reduced reliance on endoscopy.
Key Points
To evaluate abdominal ultrasound and liver and spleen point shear-wave elastography for identifying esophageal varices non-invasively in patients with schistosomiasis-associated non-cirrhotic portal hypertension.
Conducted a prospective, cross-sectional study in Pernambuco, Brazil, enrolling 71 patients with schistosomiasis-associated non-cirrhotic portal hypertension.
Evaluated patients using upper abdominal ultrasonography, liver and spleen stiffness measurements via point shear-wave elastography (pSWE) on a Siemens Acuson S2000 system, and upper gastrointestinal endoscopy.
Esophageal varices occurred in 64.8% of patients (46/71) and were significantly associated with splenic index (p = 0.002), splenic vein diameter (p < 0.001), and spleen stiffness on pSWE (p < 0.001), whereas liver-related parameters showed weaker predictive value.
Splenic parameters showed strong diagnostic performance for detecting varices, yielding area under the ROC curves of 0.800 for spleen stiffness, 0.783 for splenic vein diameter, and 0.821 for a combined model of splenic index and stiffness, with no significant differences between them by DeLong's test.