Right liver lobe/albumin ratio:Contribution to non-invasive assessment of portal hypertension

AIM:To study the value of biochemical and ultraso- nographic parameters in prediction of presence and size of esophageal varices. METHODS:The study includes selected cirrhotic patients who underwent a complete biochemical workup, upper digestive endoscopic and ultrasonographic examinations.Albumin/right liver lobe diameter and platelet count/spleen diameter ratios were calculated. The correlation between calculated ratio and the presence and degree of esophageal varices was evaluated. RESULTS:Ninety-four subjects(62 males,32 females), with a mean age of 52.32±13.60 years,were studied. Child-Pugh class A accounted for 42.6%,class B 37.2%, whereas class C 20.2%.Esophageal varices(OE)were not demonstrated by upper digestive endoscopy in 24.5%,while OE gradeⅠwas found in 22.3% patients, gradeⅡin 33.0%,gradeⅢin 16.0%,and gradeⅣin 4.3%.The mean value of right liver lobe diameter/ albumin ratio was 5.51±1.82(range from 2.76 to 11.44),while the mean platelet count/spleen diameter ratio was 1017.75±729.36(range from 117.39 to 3362.50),respectively.Statistically significant correlation was proved by Spearman’s test between OE grade and calculated ratios.The P values were 0.481 and-0.686, respectively. CONCLUSION:The right liver lobe diameter/albumin and platelet count/spleen diameter ratios are non- invasive parameters providing accurate information pertinent to determination of presence of esophageal varices,and their grading in patients with liver cirrhosis.