Performance of spleen stiffness measurement to rule out high-risk varices in patients with porto-sinusoidal vascular disorder.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Moga Lucile, Paradis Valérie, Ferreira-Silva Joel, Gudavalli Koushik, Indulti Federica, Dajti Elton, Nicoara-Farcau Oana, Tosetti Giulia, Antonenko Antonina, Fodor Andreea, Vidal-González Judit, Turco Laura, Capinha Francisco, Elkrief Laure, Monllor-Nunell Teresa, Goria Odile, Balcar Lorenz, Lannes Adrien, Mallet Vincent, Poujol-Robert Armelle, Thabut Dominique, Houssel-Debry Pauline, Wong Yu Jun, Ronot Maxime, Vilgrain Valérie, Rampally Sai Prasanth, Payancé Audrey, Castera Laurent, Reiberger Thomas, Ferrusquía-Acosta José, Noronha Ferreira Carlos, Vitale Giovanni, Simon-Talero Macarena, Procopet Bogdan, Berzigotti Annalisa, Caccia Riccardo, Turon Fanny, Schepis Filippo, Ravaioli Federico, Colecchia Antonio, Valsan Arun, Macedo Guilherme, Plessier Aurélie, Rautou Pierre-Emmanuel, ERN RARE-LIVER; a study of VALDIG, an EASL consortium
Аннотация
APPROACH AND RESULTS: We retrospectively included patients with PSVD, ≥1 sign of portal hypertension, without a history of variceal bleeding, who underwent an SSM-VCTE within 2 years before or after an upper endoscopy in 21 VALDIG centers, divided into a derivation and a validation cohort. One hundred fifty-four patients were included in the derivation cohort; 43% had HRV. By multivariable logistic regression analysis, SSM-VCTE >40 kPa and serum bilirubin ≥1 mg/dL were associated with HRV. SSM-VCTE ≤40 kPa combined with bilirubin <1 mg/dL had a sensitivity of 96% to rule out HRV and could spare 38% of screening endoscopies, with 4% of HRV missed, and a 95% negative predictive value. In the validation cohort, including 155 patients, SSM combined with bilirubin could spare 21% of screening endoscopies, with 4% of HRV missed and a 94% negative predictive value.
CONCLUSIONS: This study gathering a total of 309 patients with PSVD showed that SSM-VCTE ≤40 kPa combined with bilirubin <1 mg/dL identifies patients with PSVD and portal hypertension with a probability of HRV <5%, in whom screening endoscopy can be spared.