الفهرس 
Measurement of splenic stiffness in the prediction of oesophageal varices and the response to carvedilol therapy in portal hypertensive patients
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Abstract
This was a single-center, prospective cross-sectional study, conducted on 110 individuals (90 chronic HCV patients and 20 healthy controls). All patients enrolled were over 18 years of age. Patients with transient elastography technical difficulty, contraindication to Ý-blocker therapy, pregnant females, those receiving portal hypotensive medications, and those undergone previous endoscopic management of esophageal varices were excluded from the beginning. Each patient underwent abdominal ultrasound and laboratory investigations, cirrhotic patients (60) were furtherly subjected to doppler ultrasonography to confirm portal hypertension, then upper endoscopy to verify the presence of esophageal varices, patients with esophageal varices were prescribed carvedilol (6.25mg twice daily) (30). Liver and spleen stiffness was done for all patients once and it was repeated again for patients who received carvedilol after three month of treatment as described. Results There was statistical significant difference between all groups in terms of both liver and spleen stiffness (P<0.001). An inverse correlation was found between spleen stiffness before treatment in cirrhotic patients with esophageal varices and the spleen size (R-value -.438, P=0.016). In cirrhotic patients with varices treated with carvedilol, a statistical significant difference was found before and after treatment (P<0.001). Spleen stiffness measurement was capable of predicting the presence of esophageal varices at cut off 59.85kPa with AUC 0.768, showing sensitivity 80% and specificity 70%. However, neither spleen stiffness nor platelet count to spleen size ratio were capable of predicting the size of the varices