Contribution of Ultrasonic Impulse Elastometry (Fibroscan<sup>®</sup>) in the Evaluation of the Severity of Portal Hypertension (PH) in Cirrhotic Patients

Purpose: To establish a threshold value of liver elasticity for the prediction of esophageal varices in compensated cirrhotics. Methodology: retrospective and analytical study carried out in outpatient hepato-gastroenterology consultations and in the digestive endoscopy unit of the Cocody University Hospital during the period from July 2018 to July 2022. All patients with compensated cirrhosis of etiologies were included. Various, having carried out a Fibroscan and an esogastroduodenal fibroscopy (FOGD). Data were analyzed using SPSS 26 statistical software. Patients were separated into two groups with or without esophageal varices (OV) according to FOGD results. Chi 2 and Fisher’s test were used to compare the two groups. The respective optimal predictive threshold for the diagnosis of esophageal varices was determined from the ROC curve. The respective diagnostic performances of this threshold were evaluated by their sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV). Results: 50 patients were retained. The mean age was 43.7 ± 9 years for group I (without OV) and 49 ± 12.9 years for group II (with OV). The sex ratio was 1.55 in group I and 2.85 for group II. Viral etiology B was predominant in both groups (78.3% vs 74.1%). Thrombocytopenia was present in both groups (69.6% vs 70.4%). In group II the grade II and III OV with red signs were respectively (18% vs. 14%). The median Liver Elasticity Threshold (FLS) of the two groups was (18.5 kPa vs 31 kPa). The elasticity threshold of the liver was 25.15 kPa to predict the presence of esophageal varices. The area under the AUROC curve was 0.928 (95% CI 0.82 to 1) with a P value of less than 0.001. The Fibroscan performed well with a sensitivity of 85% and a specificity of 82.6%, a PPV of 84.6%, a VPN of 79.2%. Conclusion: Fibroscan is a powerful non-invasive test for predicting the presence of esophageal varices in compensated cirrhotics.