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العنوان
Role of Transient Elastography in Prediction of Esophageal Varices in Patients with HCVrelated
Chronic Liver Disease/
المؤلف
EL Wakil, Noha Mamdouh.
هيئة الاعداد
باحث / Noha Mamdouh EL Wakil
مشرف / Ali Ahmed Zaki Helmy
مشرف / Waleed Abd EL Aaty Hamed
مشرف / Mohammed Omar khalifa
مشرف / Enas Hassan Allam
تاريخ النشر
2015.
عدد الصفحات
149p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
الكبد
تاريخ الإجازة
1/1/2015
مكان الإجازة
جامعة عين شمس - كلية الطب - المناطق الحارة
الفهرس
Only 14 pages are availabe for public view

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Abstract

The aim of our study was to evaluate the accuracy of liver
stiffness measurements performed using transient elastography as
a non-invasive tool for prediction of the presence and the size of
esophageal varices in patients with HCV- related chronic liver
disease.
This cross sectional analytic study included sixty patients
with HCV- related chronic liver disease patients who fulfilled
inclusion criteria. All patients were subjected to full history
taking, full clinical examination, laboratory investigations,
abdominal ultrasonography, diagnostic upper GIT endoscopy and
Liver stiffness measurements (LSM) using Fibroscan.
According to presence of esophageal varices, patients were
divided into two groups:
Group I: Patients with no esophageal varices (19 patients).
Group II: Patients with esophageal varices (41 patients).
Group II were further subdivided into two subgroups:
Group (II a): Patients with small varices (12 patients).
Group (II b): Patients with medium and large varices
(29 patients).As regard demographic data, the results revealed that
number of male patients in group II was more than that of group
I, similarly, patients coming from rural areas were more in group
II than group I.
Regarding clinical examination, there was a high
statistically significant difference between both groups as regard
detection of papable spleen which was more in group II than in
group I.
On comparising the laboratory findings, we found that
platelet count was lower in group II than in group I, and also, it
was lower in group IIb than group IIa.
Regarding ultrasound findings, there was a highly
significant difference in spleen diameter and portal vein diameter
between the groups, where it was larger in group II than group I,
and also in group IIb than group IIa.
Regarding liver stiffness measurements as a predictor for
the presence of esophageal varices, the results of our study
showed that transient elastography was a useful technique for
predicting presence of esophageal varices, with the best cutoff
value >20 Kpa with a sensitivity of 97.56% and a specificity of
94.74%, while the best cutoff value in detection of medium and
large esophageal varices was > 35 Kpa with a sensitivity of
75.86% and a specificity of 100% Regarding platelet count/spleen diameter ratio in our
study, the best cutoff value for diagnosis of presence esophageal
varices was ≤ 800 with a sensitivity of 95.1% and a specificity of
78.9 %, while the best cutoff value in detection of medium and
large esophageal varices was ≤ 588.23 with a sensitivity of
65.5% and a specificity of 100%.