Transient Elastography (Fibroscan) Compared to Diagnostic Endoscopy in the Diagnosis of Varices in Patients with Cirrhosis

Abstract

We evaluated the effectiveness of the Transient elastography using (Fibroscan) for the prediction of varices and portal hypertensive gastropathy in patients with chronic liver disease. We performed a cross-sectional study of patients with compensated chronic liver disease who had never experienced variceal bleeding and underwent both a Fibroscan assessment for liver fibrosis and a diagnostic UGIE no more than 3 months apart. We collected the patients’ demographic data, serum ALT and platelet count values, and Fibroscan and endoscopy results. We included 75 patients in the final analysis; 39 (52%) had males. Hepatitis C was the most common diagnosis (27, 36%). A total of 37 patients (49.3%) had either gastric or esophageal varices (OV), portal hypertensive gastropathy (PHG), or both. The mean stiffness score was 30.1 kPa (SD 1.2 kPa). The Fibroscan score was highly correlated with the presence of varices (r=.85 and P=.002). The mean stiffness score was higher in patients with OVs or PHG than in patients without OVs or PHG, (34.5, SD 18.3 and 25.8, SD 14.9, respectively, P=.027), but no difference was found in the stiffness scores between the patients with small and large varices. The ROC analysis of a stiffness score showed AUC of.67 for the detection of varices. In conclusion: Fibroscan can predict the presence of varices and PHG in patients with cirrhosis, but it cannot distinguish between small and large varices.