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Comparison Value of Platelet Count /Splenic Diameter Ratio vs Portal System Doppler Study Results for Prediction/Screening of Esophageal Varices

Author(s): Roozbeh Barikbin | Ali Hekmatnia | Navid Omidifar | Maryam Farghadani | Peiman Adibi

Journal: Iranian Journal of Radiology
ISSN 1735-1065

Volume: 6;
Issue: S1;
Start page: 78;
Date: 2009;
Original page

"nIntroduction: It is currently recommended that all patients with liver cirrhosis undergo upper gastrointestinal endoscopy (UGIE) to identify those who have esophageal varices (EV) that carry a high risk of bleeding and may benefit from prophylactic measures. In the future, this social and medical burden will increase due to the greater number of patients with chronic liver disease and their improved survival. "nAIM: To compare value of platelet count/spleen diameter ratio (PC/SD ratio) Vs Doppler sonography for the prediction/screening of esophageal varices (EV) in cirrhotic patients. "nMaterials and Methods: In this two-year prospective study, patients with liver cirrhosis referred to Al -Zahra hospital were enrolled. Patients underwent detailed clinical examination, blood tests (hematology, liver function tests), ultrasonography and Doppler sonography of the hepato-portal system. The size of esophageal varices were assessed at UGIE; Paquet's grades 0 – III were classified as group A (0-I; no or mild EV) and group B (II-III; moderate to severe EV). PC/SD ratio was also measured. The degree of esophageal varices were assessed at UGIE. The relationship of the presence and the degree of EVs with PC/SD ratio and Doppler results were evaluated. "nResults: 50 consecutive cirrhotic patients (age range, 52.1 ±16.2 years; 41 male and 9 female) were enrolled. 19 (38%) patients were placed in group A (no or mild EV) while 31(62%) had endoscopic evidence of moderate to severe esophageal varices (group B). PC/SD ratio ROC area under the curve was significant and could significantly predict high risk EV but Doppler ROC area under the curve was not significant but was near significant(AUC=0.64 ). PC/SD ratio was more sensitive and has more NPV than Doppler results. "nConclusion: The PC/SD ratio and Doppler results are independently associated with the presence of EV and can predict its severity in patients with cirrhosis. Although Doppler results were very useful,they should get more attention and popularity in order,to be used. We think PC/SD ratio can be more helpful for the primary screening of EVs because it is more sensitive and accurate and costs less than Doppler. Moreover we think Doppler study can be helpful for further investigation and the finding of more established and unchangeable information.  
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