Skip to main content

ORIGINAL RESEARCH article

Front. Med.
Sec. Hepatobiliary Diseases
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1443581
This article is part of the Research Topic Treatment and Prognostic Assessment of Liver Cirrhosis and Its Complications, Volume II View all 15 articles

Correlation between the diameter of esophageal varices measured by virtual ruler under endoscopy and portal pressure gradient

Provisionally accepted
Yudi Mao Yudi Mao 1,2Zhongliang Fang Zhongliang Fang 1,2Yingying He Yingying He 1Jing Jin Jing Jin 1Xiping Ding Xiping Ding 2Derun Kong Derun Kong 1*
  • 1 First Affiliated Hospital of Anhui Medical University, Hefei, China
  • 2 Anhui Provincial Hospital, Hefei, Anhui Province, China

The final, formatted version of the article will be published soon.

    Background: Esophageal variceal diameter (EVD) is a crucial factor in determining the risk of esophageal variceal bleeding, which arises from an increased portal pressure gradient (PPG). However, research on the relationship between EVD and PPG has been limited, primarily because the assessment of EVD depends on visual estimation during endoscopy. Recently, we developed a method utilizing artificial intelligence (AI) to detect EVD. In this study, we aim to investigate the correlation between EVD and PPG, with the objective of evaluating the potential of using EVD to assess PPG.Comprising retrospective and prospective data, a total of 128 patients with portal hypertension and gastroesophageal varices from two medical institutions were included in this study. Clinical information including PPG, biochemical markers and blood routine was collected. Retrospectively, EVD was evaluated using an AI-based virtual ruler In the prospective phase, the measurement of PPG was conducted through radiation intervention methods, and EVD was measured during endoscopy with the aid of AI.Results: A positive correlation between PPG and EVD (r=0.521, P<0.001) was identified, which was further corroborated by multivariate linear regression analysis (b=6.521, t=6.872, P<0.001). Upon dividing the data into two groups based on PPG levels, (27 cases with PPG<20mmHg and 101 cases with PPG≥20mmHg group), a significant difference in EVD was observed between the groups (OR=29.275, 95% CI 5.590-153.404, P<0.001), with larger EVD in the higher PPG group. These findings suggest that EVD could serve as a predictor of adverse events associated with elevated PPG levels. In addition, the ROC curve analysis indicated that EVD had an accuracy of 0.814 in diagnosing PPG function (Standard error 0.048, 95% CI 0.720-0.908; P<0.001), suggesting that PPG levels might exceed 20mmHg when the variceal diameter surpassed 1.1 cm.EVD exhibited a positively association with PPG and could potentially predict and assess PPG levels, offering novel insights for non-invasive detection of PPG.

    Keywords: Portal pressure gradient, Esophageal vein diameter, Liver Cirrhosis, Esophageal varices, portal hypertension

    Received: 04 Jun 2024; Accepted: 15 Oct 2024.

    Copyright: © 2024 Mao, Fang, He, Jin, Ding and Kong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Derun Kong, First Affiliated Hospital of Anhui Medical University, Hefei, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.