Transient elastography (Fibroscan) in prediction of esophageal varices in hepatitis C virus-related chronic liver disease: an Egyptian experience

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Abstract

Background

A marked correlation between liver stiffness and the presence of esophageal varices (EVs) has been reported. Hence, the aim of this study is to evaluate the role of transient elastography to predict EVs in patients with hepatitis C virus (HCV)-related chronic liver disease.

Patients and methods

This study included 60 patients with HCV-related chronic liver disease. All patients were subjected to clinical examination, laboratory investigations, abdominal ultrasonography, diagnostic upper gastrointestinal endoscopy, and liver stiffness measurement using Fibroscan. Patients were divided into two groups: group I included patients with no varices (19 patients) and group II included patients with varices (41 patients), who were subdivided into two subgroups – group IIa, small varices (12 patients), and group IIb, medium and large varices (29 patients).

Results

Transient elastography (Fibroscan) readings revealed a statistically significant difference between group II and group I (40.05 vs. 16.37 kPa, respectively) and between group IIb and group IIa (44.72 vs. 28.75 kPa, respectively) with a P value of 0.0001. The best cutoff value of transient elastography in the diagnosis of EVs was more than 20 kPa, with area under the receiver operating characteristic of 0.978 and a sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy of 97.56, 94.74, 97.6, 94.7, and 96.6%, respectively. The best cutoff value for the diagnosis of medium and large EVs was more than 35 kPa, with area under the receiver operating characteristic of 0.898, and sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy of 97.56, 94.74, 97.6, 94.7, and 96.6%, respectively.

Conclusion

Transient elastography (Fibroscan) can predict the presence of EVs and large varices and may help to select patients for endoscopic screening.

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