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Transient elastography: a meta-analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease.
MedLine Citation:
PMID:  22973991     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Transient elastography (TE), as a non-invasive method, has been studied for evaluation of portal hypertension in patients with chronic liver diseases (CLD) with variable results. We studied the performance of TE for detection of significant portal hypertension, oesophageal varices and large oesophageal varices using meta-analysis. METHODS: PubMed, the Cochrane Library, EMBASE and ISI web of Knowledge were searched. The studies published in English relating to the diagnostic value of TE for significant portal hypertension, oesophageal varices and large oesophageal varices in patients with CLD were collected. RESULTS: A total of 18 studies, which included 3644 patients were analysed. Summary sensitivity and specificity were 0.90 (95% confidence interval (CI), 0.81-0.95) and 0.79 (95% CI, 0.58-0.91) for significant portal hypertension, and 0.87 (95% CI, 0.80-0.92) and 0.53 (95% CI, 0.36-0.69) for oesophageal varices and 0.86 (95% CI, 0.71-0.94) and 0.59 (95% CI, 0.45-0.72) for large oesophageal varices respectively. The HSROCs were 0.93 for significant portal hypertension, 0.84 for oesophageal varices and 0.78 for large oesophageal varices respectively. TE was very informative with 81% probability of correctly detection significant portal hypertension following a 'positive' measurement (over the threshold value) and lowering the probability of disease to as low as 11% when 'negative' measurement (below the threshold value) when pre-test probability was 50% whereas, for oesophageal varices or large oesophageal varices, the probability of a correct diagnosis following a 'positive' measurement did not exceeded 70%. CONCLUSIONS: TE could be used as a good screening tool for significant portal hypertension, but only moderate diagnostic utility for the prediction of oesophageal varices or large oesophageal varices.
Authors:
Ke-Qing Shi; Yu-Chen Fan; Zhen-Zhen Pan; Xian-Feng Lin; Wen-Yue Liu; Yong-Ping Chen; Ming-Hua Zheng
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-14
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  -     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Department of Infection and Liver Diseases, Liver Research Center, , The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China; Institute of Hepatology, Wenzhou Medical College, Wenzhou, China.
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