Comparison of sound touch elastography and liver fibrosis scores in assessing high-risk esophageal varices in patients with liver cirrhosis

Purpose To evaluate and compare the diagnostic efficiency of sound touch elastography (STE) and liver fibrosis scores (APRI, FIB-4) for high-risk esophageal varices (HREV) in patients with liver cirrhosis, providing evidence for clinical application of STE.

Methods 148 patients diagnosed with liver cirrhosis in the Third Affiliated Hospital of Sun Yat-sen University between August 2018 and December 2021 were included. Clinical data and serological results were collected. Patients underwent electronic gastroscopy, abdominal ultrasound, and STE examinations for liver/spleen stiffness measurement. With gastroscopy as the gold standard, Logistic regression was performed to identify the independent risk factors for HREV, and construct the regression model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to assess the diagnostic efficiency of each non-invasive model.

Results Spleen stiffness and platelet count (PLT) were the independent risk factors of HREV. The regression model was established as Logit P = 0.125 × spleen stiffness (kPa)−0.018 × PLT (×10⁹/L)−2.262. The AUC for liver stiffness, spleen stiffness, the regression model, APRI, and FIB-4 was 0.67 (0.59, 0.75), 0.83 (0.76, 0.88), 0.86 (0.79, 0.91), 0.69 (0.61, 0.76) and 0.75 (0.68, 0.82), respectively.

Conclusion The regression model based on spleen stiffness and PLT shows high diagnostic value for HREV in patients with liver cirrhosis, which outperforms APRI and FIB-4.