Diagnostic accuracy of Right liver lobe Diameter/ Albumin ratio for Non-invasive detection of Oesophageal Varices in Hepatitis C related Cirrhosis

Abstract

Objective: To determine the diagnostic accuracy of Right Liver Lobe diameter/Albumin
concentration ratio as a parameter for non-invasive detection of oesophageal varices without
using endoscopy in patients with liver cirrhosis due to Hepatitis C.
Methods: The study was a descriptive cross-sectional study, carried out in Medical Unit 4 of
Services Hospital Lahore, over a period of 6 months. A total of 165 patients with hepatitis C related
liver cirrhosis fulfilling the inclusion/exclusion criteria were enrolled. Right liver lobe diameter was
seen transabdominal ultrasonography. Serum albumin levels of each patient were obtained and
right liver lobe diameter/albumin ratio calculated. These patients then had diagnostic upper
gastrointestinal endoscopy, which was performed by a single endoscopist and presence or
absence of oesophageal varices was documented in each case.
Results: The subjects had a mean age of 49.21+10.88 years; 52.73% were male and 47.27%
were females. The frequency of oesophageal varices detected by Upper GI endoscopy in these
liver cirrhotics due to Hepatitis C was 41.21%. The diagnostic accuracy of right liver lobe
diameter/albumin concentration ratio for detection of oesophageal varices in liver cirrhosis due to
Hepatitis C, where the gold standard test was upper GI endoscopy, was calculated as sensitivity
of 86.76%,specificity of 86.60%, positive predictive value of 81.94%,negative predictive value of
90.32% and accuracy rate of 86.67%.
Conclusions: The right liver lobe diameter/albumin concentration ratio is an accurate
diagnostic modality for the detection of oesophageal varices noninvasively in patients of liver
cirrhosis