Comparative study for the prediction of large oesophagheal varices by ultrasound doppler and serum markers in portal hypertension due to liver cirrhosis
Journal Title: The Journal of Medical Research - Year 2018, Vol 4, Issue 1
Abstract
Introduction: Number of non-invasive tests of fibrosis has shown favorable results in identifying patients with portal hypertension and large varices. On the other hand, the performance of non-invasive tests is suboptimal and often unclear. Aims & Objectives: Authors aimed to compare serum marker based indices and portal vein diameter assessed by ultrasound in portal hypertension due to chronic liver diseases for prediction of large oesophageal varices graded on endoscopy. Methods & Study Design: In this case control study, 30 patients with large varices were compared with 27 controls with suggestion of either portal hypertension or fatty liver disease. Ultrasound was the sole modality to measure portal vein diameter and assess blood flow in the splenic and portal veins to rule out thrombosis. Liver was evaluated as normal, fatty liver and cirrhosis based on sonography features. Serum markers were used to derive indices APRI, FiB4, Forn's Index, and Lok Score. Data analysis was done by using SPSS software for computation of Area under Receiver Operative Curve values. Results: The mean portal vein size did not suggest portal hypertension in control group (criteria>13mm). The mean portal vein diameter of large varices was (13.03±2.03) mm. Area under Curve plotted for all non-invasive parameters of portal hypertension with 95% CI revealed that portal vein was significantly better than serum-based markers.(p=<0.0001). Conclusion: Forns index, APRI, FIB-4 and APRI, LOK were less accurate noninvasive markers to predict large oesophageal varices as compared to portal vein diameter
Authors and Affiliations
Bhumika Vaishnav, Arvind Bamanikar, Ladli Chatterjee, Gaganpreet Grewal, Arjun Lal Kakrani
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