Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

Razek, Ahmed Abdel Khalek Abdel; Massoud, S; Azziz, Mona Ramadan Abdel; El-Bendary, Mahmoud; Zalata, Khaled; Motawea, Enas Mohamed

doi:10.1007/s00261-015-0391-2

Cited by 40 publications

(16 citation statements)

References 29 publications

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“…Studies show that together with liver and spleen stiffness measurements, PTC correlates with significant portal HTN and particularly in the presence of varices. The risk of having varices increases with decreasing PTC and have been used to assess the presence of varices non-invasively[ 37 - 40 ].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Gotlieb¹,

Schwartz²,

Zelber‐Sagi³

et al. 2020

WJG

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BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide. The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur. A major challenge is to diagnose advanced fibrosis as early as possible, using simple and non-invasive diagnostics tools. Thrombocytopenia represents advanced fibrosis and portal hypertension (HTN) and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor. However, little is known about the association between longitudinal changes in platelet counts (PTC), when still within the normal range, and the risk of cirrhosis. AIM To explore whether platelet counts trajectories over time, can predict advanced liver fibrosis across the different etiologies of liver diseases. METHODS A nested case-control study utilizing a large computerized database. Cirrhosis cases ( n = 5258) were compared to controls ( n = 15744) matched for age and sex at a ratio of 1:3. All participants had multiple laboratory measurements prior to enrollment. We calculated the trends of PTC, liver enzymes, bilirubin, international normalized ratio, albumin and fibrosis scores (fibrosis-4 and aspartate transaminase-to-platelet ratio index) throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls. The association between PTC, cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated. RESULTS The mean age in both groups was 56 (SD 15.8). Cirrhotic patients were more likely to be smokers, diabetic with chronic kidney disease and had a higher prevalence of HTN. The leading cirrhosis etiologies were viral, alcoholic and fatty liver disease. The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL. This trend was consistent regardless of sex, cirrhosis etiology and was more pronounced in patients who developed varices and ascites. Compared to controls whose values remained in the normal range, in the cirrhosis group aspartate aminotransferase and alanine aminotransferase, increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis. In multivariable regression analysis, a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis (95%CI 1.25-1.35). CONCLUSION In the preceding years before the diagnosis of cirrhosis, there is a progressive decline in PTC, within the normal range, matched to a gradual increase in fibrosis scores.

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Section: Discussionmentioning

confidence: 99%

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Gotlieb¹,

Schwartz²,

Zelber‐Sagi³

et al. 2020

WJG

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“…[ 23 – 26 ] Complications of cirrhosis such as esophageal varices and minimal hepatic encephalopathy can be predicted and detected in patients with diffusion-weighted MRI of the abdomen and diffusion-weighted MRI and proton MRS of the brain. [ 27 , 28 ] Diffusion-weighted MRI also can detect hepatic and splenic infiltration and disease severity in inherited metabolic liver disease such as Gaucher disease. [ 29 ] However, these MR-based methods are impractical or too expensive for large-scale case finding.…”

Section: Discussionmentioning

confidence: 99%

The correlation between controlled attenuation parameter and metabolic syndrome and its components in middle-aged and elderly nonalcoholic fatty liver disease patients

Dong²,

Qu³

et al. 2018

Medicine

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This study aims to investigate the correlation between controlled attenuation parameter (CAP) and metabolic syndrome (MetS) and its components in middle-aged and elderly nonalcoholic fatty liver disease (NAFLD) patients.Middle-aged and elderly patients with NAFLD, who visited our hospital from June 2016 to May 2017, were enrolled as study subjects, whereas middle-aged and elderly patients without liver disease were enrolled as controls in the same period. The prevalence of MetS, MetS components, and the different numbers of MetS components were compared among patients with different CAP values.As the CAP value increased, the prevalence of MetS, MetS components, and the different numbers of MetS components significantly increased. The CAP value was positively correlated with the prevalence of MetS, obesity, hypertriglyceridemia, hypertension, hyperglycemia, hyperuricemia, and the number of MetS components, and was negatively correlated with the prevalence of hypo–high-density-lipoprotein cholesterolemia.CAP values are closely correlated to MetS and its components in middle-aged and elder NAFLD patients. CAP may be an indicator of risk of MetS and the severity of metabolic disorders in middle-aged and elderly NAFLD patients.

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“…Diffusion-weighted MRI of the liver is well established for the detection and characterization of hepatic lesions (23)(24)(25). DWI represents the mobility of water molecules (molecular diffusion) in a tissue, which can be described by the ADC value or the intravoxel incoherent motion model (26).…”

Section: Discussionmentioning

confidence: 99%

Does steatosis affect the performance of diffusion-weighted MRI values for fibrosis evaluation in patients with chronic hepatitis C genotype 4?

Besheer¹,

Razek²,

Bendary³

et al. 2017

Turk J Gastroenterol

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Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen

Abstract: The ADC value of the spleen can predict esophageal varices in cirrhotic patients and is well correlated with the clinical and laboratory biomarkers of esophageal varices.

Cited by 40 publications

References 29 publications

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

The correlation between controlled attenuation parameter and metabolic syndrome and its components in middle-aged and elderly nonalcoholic fatty liver disease patients

Does steatosis affect the performance of diffusion-weighted MRI values for fibrosis evaluation in patients with chronic hepatitis C genotype 4?

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