The role of liver stiffness measurement in the evaluation of liver function and esophageal varices in cirrhotic patients.

ObjectiveWe aimed to evaluate the efficacy of liver stiffness measurement (LSM) in predicting the presence and severity of esophageal varices (EV) and investigating its association with liver function (LF) in patients with liver cirrhosis. MethodsMedical records of 90 cirrhotic patients who underwent LSM by transient elastography were retrospectively reviewed. The relationship between LSM and the presence and severity of EV was evaluated by esophagogastroduodenoscopy (EGD) and multislice spiral computed tomography (MSCT). Another 25 healthy individuals were included as controls. ResultsLSM was significantly associated with the Child-Pugh score in cirrhotic patients, with the highest LSM in those with Child-Pugh C. Patients with clinically decompensated cirrhosis had a higher LSM than those with compensated cirrhosis (36.7516.54kPa vs 17.65 +/- 10.87kPa, P<0.01). However, there was no significant difference in LSM value between patients with severe EV and those with no or non-severe EV determined by endoscopy (28.18 +/- 17.44kPa vs 31.00 +/- 18.44kPa) or MSCT (29.71 +/- 18.39kPa vs 24.90 +/- 14.80kPa). The diagnostic value of LSM for predicting severe EV was low in unselected cirrhotic patients. The presence of EV examined by EGD and MSCT was similar to each other. ConclusionsLSM could be used to evaluate the progression of liver cirrhosis continuously. However, its role in assessing EV grades in advanced cirrhosis needs further confirmation. MSCT can assess EV accurately and may serve as an alternative to endoscopy in the assessment of portal hypertension.