Abstract: Objective To explore the value of hemodynamics of liver and spleen, stiffness of liver and spleen and laboratory test results in predicting the degree of esophageal and gastric varices in hepatitis B-induced liver cirrhosis patients, to screen the independent risk factors and to obtain the quantitative nomogram model. 
Methods In total, 128 patients with hepatitis B-induced liver cirrhosis who met the criteria were included in the Second Hospital of Hebei Medical University. According to the results of endoscopy, patients without varicose veins (G0) and patients with mild varicose veins (G1) were selected as low-risk group, and patients with moderate (G2) and severe (G3) varicose veins as high-risk group. The data including height, weight, body mass index (BMI), portal vein diameter, portal vein velocity, hepatic artery systolic velocity, diastolic velocity, resistance index, spleen thickness, splenic vein diameter at the splenic hilum, splenic vein velocity, liver and spleen stiffness values, white blood cells, red blood cells (RBC), hemoglobin, platelets, aspartate aminotransferase, alanine aminotransferase, albumin, total bilirubin and creatinine were collected from the two groups. Independent risk factors for predicting the degree of esophageal and gastric varices were screened through univariate analysis and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of each factor and composite index, and a quantitative model was obtained through a nomogram. 
Results The results of univariate analysis showed that there was a significant difference in portal vein diameter, portal vein velocity, liver stiffness, spleen stiffness, and RBC count between the two groups (P＜0.05). Further multivariate logistic regression analysis showed that portal vein velocity, liver stiffness, and spleen stiffness were independent risk factors for high-risk esophageal and gastric varices (P＜0.05). ROC curve analysis showed that each factor had high sensitivity and specificity, especially the area under ROC curve of the spleen stiffness was as high as 0.92. 
Conclusion Multimodal ultrasound of liver and spleen can quantitatively predict the risk of esophageal and gastric varices bleeding in patients with hepatitis B-induced liver cirrhosis, the index of spleen stiffness has high diagnostic efficiency. 

Key words: liver cirrhosis, esophageal and gastric varices, multimodal ultrasound