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

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2024年10月29日

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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

摘要

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.