⚡ Quick Summary
This study explored the relationship between esophageal variceal diameter (EVD) and portal pressure gradient (PPG), revealing a significant positive correlation. The findings suggest that EVD could serve as a non-invasive predictor of PPG levels, enhancing clinical assessments for patients with portal hypertension.
🔍 Key Details
- 📊 Participants: 128 patients diagnosed with portal hypertension and gastroesophageal varices
- 🧩 Methodology: AI-based virtual ruler for EVD measurement during endoscopy
- ⚙️ Analysis: Multivariate linear regression and ROC curve analysis
- 🏆 Key Findings: Positive correlation (r = 0.521, P < 0.001) between EVD and PPG
🔑 Key Takeaways
- 📊 EVD is a crucial factor in assessing the risk of esophageal variceal bleeding.
- 💡 AI technology enhances the accuracy of EVD measurement during endoscopy.
- 👩🔬 Significant correlation found between EVD and PPG (r = 0.521).
- 🏆 EVD accuracy in diagnosing elevated PPG levels was 0.814.
- 🌍 Larger EVD observed in patients with PPG ≥ 20 mmHg (OR = 29.275).
- 🔍 Non-invasive assessment of PPG could improve patient management strategies.
- 📈 Study conducted across two medical institutions.
- 🆔 Citation: Mao Y, et al. Front Med (Lausanne) 2024; 11:1443581.
📚 Background
Esophageal varices are dilated veins in the esophagus that can lead to serious complications, including bleeding. The diameter of these varices is a critical indicator of bleeding risk, which is closely linked to the portal pressure gradient (PPG). Traditionally, assessing EVD has relied on visual estimation during endoscopy, which can be subjective and inconsistent. The advent of artificial intelligence (AI) offers a promising solution to enhance measurement accuracy and provide better clinical insights.
🗒️ Study
This research included both retrospective and prospective analyses involving 128 patients diagnosed with portal hypertension and gastroesophageal varices. The study aimed to investigate the correlation between EVD and PPG, utilizing an AI-based virtual ruler for precise EVD measurement during endoscopy. The prospective phase involved measuring PPG through radiological interventions, allowing for a comprehensive evaluation of the relationship between these two critical parameters.
📈 Results
The study identified a strong positive correlation between PPG and EVD, with a correlation coefficient of r = 0.521 and a significance level of P < 0.001. Multivariate linear regression analysis further supported these findings, indicating that EVD could effectively predict PPG levels. Notably, patients with a PPG ≥ 20 mmHg exhibited significantly larger EVD compared to those with lower PPG levels, underscoring the potential of EVD as a predictive marker for adverse events related to elevated portal pressure.
🌍 Impact and Implications
The implications of this study are profound for clinical practice. By establishing EVD as a reliable, non-invasive predictor of PPG, healthcare providers can enhance their ability to assess and manage patients at risk of esophageal variceal bleeding. This advancement could lead to improved patient outcomes and more effective monitoring strategies in the management of portal hypertension. The integration of AI in clinical assessments represents a significant step forward in gastroenterology.
🔮 Conclusion
This study highlights the potential of EVD as a predictive marker for assessing portal pressure levels, paving the way for non-invasive evaluation methods in clinical settings. The positive correlation between EVD and PPG opens new avenues for research and clinical application, emphasizing the importance of integrating advanced technologies like AI in healthcare. Continued exploration in this field is essential for enhancing patient care and outcomes.
💬 Your comments
What are your thoughts on the use of AI in measuring esophageal variceal diameter? We would love to hear your insights! 💬 Share your comments below or connect with us on social media:
Correlation between the diameter of esophageal varices measured using a virtual ruler under endoscopy and portal pressure gradient.
Abstract
BACKGROUND: Esophageal variceal diameter (EVD) is a crucial factor in determining the risk of esophageal variceal bleeding, which is associated with an increased portal pressure gradient (PPG). However, research into the relationship between EVD and PPG has been limited, primarily because the assessment of EVD depends on visual estimation during endoscopy. Recently, we developed an artificial intelligence (AI)-based method to accurately detect EVD. In this study, we aim to investigate the correlation between EVD and PPG, with the goal of evaluating EVD as a potential non-invasive indicator of PPG.
METHODS: This study included both retrospective and prospective data from 128 patients diagnosed with portal hypertension and gastroesophageal varices, gathered from two medical institutions. Clinical data including PPG, biochemical markers, and routine blood tests were collected. In the retrospective phase, EVD was evaluated using an AI-based virtual ruler. In the prospective phase, PPG was measured using radiological intervention methods, and EVD was measured during endoscopy with the aid of AI.
RESULTS: A positive correlation between PPG and EVD was identified (r = 0.521, P < 0.001), which was further supported by multivariate linear regression analysis (b = 6.521, t = 6.872, P < 0.001). When patients were stratified into two groups based on PPG levels (27 patients with PPG < 20 mmHg and 101 patients with PPG ≥ 20 mmHg), a significant difference in EVD was observed between the groups (OR = 29.275, 95% CI 5.590-153.304, P < 0.001), with larger EVD in the higher PPG group. These findings suggest that EVD may serve as a predictor of adverse events associated with elevated PPG levels. In addition, receiver operating characteristic (ROC) curve analysis showed 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), indicating that PPG levels are likely to exceed 20 mmHg when the variceal diameter is greater than 1.1 cm.
CONCLUSION: EVD demonstrated a positive correlation with PPG and could potentially be used as a predictive marker for assessing PPG levels. These findings provide novel insights for the non-invasive evaluation of PPG in clinical practice.
Author: [‘Mao Y’, ‘Fang Z’, ‘He Y’, ‘Jin J’, ‘Ding X’, ‘Kong D’]
Journal: Front Med (Lausanne)
Citation: Mao Y, et al. Correlation between the diameter of esophageal varices measured using a virtual ruler under endoscopy and portal pressure gradient. Correlation between the diameter of esophageal varices measured using a virtual ruler under endoscopy and portal pressure gradient. 2024; 11:1443581. doi: 10.3389/fmed.2024.1443581