간경변증 환자에서 식도정맥류 예측을 위한 자기공명 탄성영상의 유용성

Abstract

PURPOSE: To evaluate the usefulness of magnetic resonance elastography (MRE) as a non-invasive tool for predicting esophageal varices and identifying high-risk varices. MATERIALS AND METHODS: One hundred and twenty-six patients with liver cirrhosis, and who underwent both MRI including MRE of the liver as well as upper gastrointestinal endoscopy for variceal screening within one month before or after the MRI, were included in this study. The relationship between the liver stiffness values measured by MRE and the degree of esophageal varices, was assessed using Spearmans correlation analysis. In addition, the diagnostic performance of MRE for predicting the presence of varices or high-risk varices (grade ≥ II), was evaluated using the receiver-operating characteristics (ROC) curves. RESULTS: The mean stiffness values of liver parenchyma measured on MRE were well correlated to the grade of esophageal varices (r = 0.63). In addition, the MRE-based liver stiffness values were significantly lower in lower risk group than in the higher risk group (p<.0001). The area under the ROC curve values of MRE for predicting the presence of varices or high-risk varices (grade ≥ II) were 0.859 and 0.810, respectively. Using a liver stiffness cutoff value of 5.803 kilopascals (kPa), the sensitivity, specificity, positive predictive value, and negative predictive value for predicting high grade (≥ II) esophageal varices were 96%, 60%, 36%, and 98%, respectively. CONCLUSION: The MRE-based liver stiffness value may be useful for non-invasively predicting esophageal varices and identifying high-risk varices in cirrhotic patients.