For this study, researchers wanted to see how accurate noninvasive indicators like liver (LS) and spleen stiffness (SS) were at detecting esophageal varices (EV) in children with biliary atresia (BA). Between the years 2000 and 2015, children with BA were recruited. They were all subjected to esophagogastroduodenoscopy and transient elastography. Demographic information, laboratory results, the alanine transferase-to-platelet ratio index (APRI), and the Varices Prediction Rule (VPR) score were gathered. There were 51 children enrolled (mean age 10.63 years, standard deviation (SD) = 6.08 years; 53% males). There were differences between the varice and varice-free groups in the onset and outcome of portoenterostomy, spleen palpability, platelet count, albumin, LS, SS, and VPR (P<0.05). The median LS in the varice group was 18.12 (interquartile ratio (IQR) 13.15–19.12) kPa, while the median SS was 46.85 (IQR 25.95–54.55) kPa. The median LS in the varice-free group was 7.85 (IQR 5.88–16.75) kPa, while the median SS was 16.54 (IQR 11.75–21.75) kPa. Both LS and SS were greater in the varice group than in the non-variceal group (P<0001). LS, SS, spleen palpability, platelet count, APRI, and VPR had areas under the receiver operating characteristic curves of 0.734, 0.870, 0.817, 0.810, 0.751, and 0.794, respectively. The sensitivity and specificity were 75 and 87%, respectively, when using a cut-off value of 28.9 kPa for SS. The use of LS and SS together to diagnose varices enhanced the specificity to 93%.
In children with BA, SS as a single marker showed the greatest diagnostic value for predicting esophageal varices. Furthermore, the combination of SS and LS boosted diagnostic yield.
Reference:journals.lww.com/jpgn/Fulltext/2019/10000/Spleen_and_Liver_Stiffness_to_Detect_Esophageal.5.aspx
