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- Title
Prediction of high-risk esophageal varices in patients with chronic liver disease with point and 2D shear wave elastography: a systematic review and meta-analysis.
- Authors
Liu, Yue; Tan, Hao-yan; Zhang, Xiao-guang; Zhen, Yan-hua; Gao, Fan; Lu, Xue-feng
- Abstract
Objective: To assess the diagnostic performance of liver stiffness (LS) and spleen stiffness (SS) measured by point shear wave elastography (pSWE) and 2D shear wave elastography (2D-SWE) in the detection of high-risk esophageal varices (HREV) and to compare their diagnostic accuracy. Methods: Through systematic search of PubMed, Embase, and Web of Science databases, we included 17 articles reporting the diagnostic performance of LS or SS measured by pSWE or 2D-SWE for HREV. We used a bivariate random-effects model to estimate pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), area under summary receiver operator characteristic curve (AUSROC), and diagnostic odds ratio (DOR). Results: For LS, there was no significant difference between the pooled sensitivity, 0.89 (95% confidence interval CI, 0.81–0.94) vs. 0.8 (95% CI, 0.72–0.86) (p = 0.13), and specificity, 0.81 (95% CI, 0.73–0.87) vs. 0.73 (95% CI, 0.65–0.79) (p = 0.07) of pSWE and 2D-SWE. The AUSROC and DOR of pSWE were higher than those of 2D-SWE: 0.92 (95% CI, 0.89–0.94) vs. 0.84 (95% CI, 0.80–0.87), p = 0.03, 33 (95% CI, 25–61) vs. 11 (95% CI, 5–22), (p < 0.01). For SS, there was no significant difference between the pooled sensitivity 0.91 (95% CI, 0.78–0.96) vs. 0.89 (95% CI, 0.80–0.94) (p = 0.43); specificity, 0.79 (95% CI, 0.72–0.84) vs. 0.72 (95% CI, 0.63–0.79) (p = 0.06); and DOR, 35 (95% CI, 13–100) vs. 20 (95% CI, 8–50) (p = 0.16) of pSWE and 2D-SWE. Conclusion: LS and SS measured by pSWE and 2D-SWE have good accuracy in predicting HREV. Key Points: • There is modest difference between the diagnostic performance of LS and SS measured by pSWE and 2D-SWE. • LS and SS measured by pSWE and 2D-SWE both have high sensitivity, specificity, and AUSROC for the evaluation of HREV in patients with CLD. • pSWE and 2D-SWE are promising tools for noninvasive monitoring risk of esophageal varices bleeding of CLD patients.
- Publication
European Radiology, 2022, Vol 32, Issue 7, p4616
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-022-08601-0