Abstract: Objective To compare the value of magnetic resonance (MR) elastography and endoscopy in the diagnosis of esophageal and gastric varices in liver cirrhotic patients.Methods From February 2019 to February 2020, eighty patients who underwent hepatic venous pressure gradient (HVPG) examination and routine endoscopy and were diagnosed with cirrhosis complicated with esophageal and gastric varices were selected as the EGV group, which were further subdivided into mild, moderate and severe EGV groups according to their severities of the varices. At the same period of time, 74 liver cirrhotic patients without esophageal and gastric varices after HVPG examination and routine endoscopy were selected as the non-EGV group. MR elastography was used to measure liver stiffness (HS) and spleen stiffness (SS). Ultrasound endoscopy was used to measure the total cross-sectional surface area, the diameter of the splenic vein, and the diameter of the portal vein. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of MR elastography and endoscopic ultrasound in the diagnosis of cirrhosis with esophagus and gastric varices.Results The HS [(5.16±0.45) kPa], SS [(8.67±1.08) kPa], total cross-sectional surface area [(0.64±0.14) cm²], splenic vein [(15.42±1.79) mm], and portal vein [(16.71±1.84) mm] in patients of EGV group were higher than those of [(4.42±0.58) kPa, (6.84±1.04) kPa, (0.45±0.10) cm², (12.81±1.64) mm, (14.62±2.13) mm] respectively in the non-EGV group (all P<0.05). The parameters of patients in severe EGV group were higher than those of moderate and mild EGV groups (P<0.05), and the parameters of moderate EGV group were higher than those of mild EGV group (P<0.05). The areas under the curve (AUC) of HS, SS, total cross-sectional surface area, splenic vein, and portal vein for diagnosing cirrhosis complicated with esophagus and gastric varices were 0.812, 0.839, 0.888, 0.860, 0.954, respectively. By pairwise comparison it was shown that the AUCs of HS and SS were statistically significantly different from the AUC of portal vein diameter (P<0.05). The cut-off values were 4.963 kPa, 7.927 kPa, 0.541 cm², 14.602 mm, 16.054 mm, the specificities were 83.8%, 85.1%, 83.8%, 89.2%, 91.9%, and the sensitivities were 67.5%, 73.8%, 81.3%, 72.5%, 88.8%, respectively. The AUC of the combined detection was 0.998, with a specificity of 98.6%, and a sensitivity of 98.8%.Conclusion MR elastography and ultrasound endoscopy have certain diagnostic values for esophageal and gastric varices in cirrhotic patients, and ultrasound endoscopy is of a higher diagnostic value.

Key words: Liver cirrhosis, Esophageal and gastric varices, Magnetic resonance elastography, Ultrasound endoscopy, diagnosis