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Background/Aims:Periodic endoscopic screening for oesophageal varices is recommended in patients with cirrhosis,but might be limited to a subgroup of patients if a simple noninvasive test was available to select those at risk of bleeding.Methods:We studied in 165 patients with cirrhosis the relation between the presence of oesophageal varices assessed by endoscopy,and liver stiffness measurement by Fibroscan,a non-invasive parameter related to liver fibrosis.The results were compared to those of other parameters reflecting portal hypertension,splenic size,platelet count,and platelet count/spleen size ratio.Results:Liver stiffness measurement was correlated to the grade of oesophageal varices(r = 0.6,p < 0.0001) .AUROC values of liver stiffness measurement were 0.84(95% CI:0.78-0.90) for the presence of oesophageal varices and 0.83(0.76-0.89) for varices grade ≥ II.Liver stiffness measurement value < 19 kPa was highly predictive of the absence of oesophageal varices grade ≥ II(Se:84%,PPV:47%,NPV:93%) .Conclusions:Liver stiffness measurement allows to predict the presence of large oesophageal varices in patients with cirrhosis,and may help to select patients for endoscopic screening.
Background / Aims: Periodic endoscopic screening for oesophageal varices is recommended in patients with cirrhosis, but might be limited to a subgroup of patients if a simple noninvasive test was available to select those at risk of bleeding. Methods: We studied in 165 patients with cirrhosis the relation between the presence of oesophageal varices assessed by endoscopy, and liver stiffness measurement by Fibroscan, a non-invasive parameter related to liver fibrosis. results were compared to those of other parametersreport portal hypertension, splenic size, platelet count, and The platelet count / spleen size ratio. Results: Liver stiffness measurement was correlated to the grade of oesophageal varices (r = 0.6, p <0.0001) .AUROC values of liver stiffness measurement were 0.84 (95% CI: 0.78-0.90) of oesophageal varices and 0.83 (0.76-0.89) for varices grade ≧ II. Liver stiffness measurement value <19 kPa was highly predictive of the absence of oesophageal varices grade ≧ II (Se : 84%, PPV: 47%, NPV: 93%) .Conclusions: Liver stiffness measurement allows to predict the presence of large oesophageal varices in patients with cirrhosis, and may help to select patients for endoscopic screening.