Spleen stiffness measurement using fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patients
- 22 December 2010
- journal article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 26 (1), 164-170
- https://doi.org/10.1111/j.1440-1746.2010.06325.x
Abstract
Splenomegaly in a common finding in liver cirrhosis that should determine changes in the spleen's density because of portal and splenic congestion and/or because of tissue hyperplasia and fibrosis. These changes might be quantified by elastography, so the aim of the study was to investigate whether spleen stiffness measured by transient elastography varies as liver disease progresses and whether this would be a suitable method for the noninvasive evaluation of the presence of esophageal varices. One hundred and ninety-one patients (135 liver cirrhosis, 39 chronic hepatitis and 17 healthy controls) were evaluated by transient elastography for measurements of spleen and liver stiffness. Cirrhotic patients also underwent upper endoscopy for the diagnosis of esophageal varices. Spleen stiffness showed higher values in liver cirrhosis patients as compared with chronic hepatitis and with controls: 60.96 vs 34.49 vs 22.01 KPa (P<0.0001). In the case of liver cirrhosis, spleen stiffness was significantly higher in patients with varices as compared with those without (63.69 vs 47.78 KPa, P<0.0001), 52.5 KPa being the best cut-off value, with an area under the receiver operating characteristic of 0.74. Using both liver and spleen stiffness measurement we correctly predicted the presence of esophageal varices with 89.95% diagnostic accuracy. Spleen stiffness can be assessed using transient elastography, its value increasing as the liver disease progresses. In liver cirrhosis patients spleen stiffness can predict the presence, but not the grade of esophageal varices. Esophageal varices' presence can be better predicted if both spleen and liver stiffness measurements are used.Keywords
This publication has 28 references indexed in Scilit:
- Assessment of Hepatic Fibrosis With Magnetic Resonance ElastographyClinical Gastroenterology and Hepatology, 2007
- Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseasesHepatology, 2006
- Platelet Count/Spleen Diameter Ratio for the Noninvasive Diagnosis of Esophageal Varices: Results of a Multicenter, Prospective, Validation StudyMaterials, 2006
- Measurement of Portal Pressure and Its Role in the Management of Chronic Liver DiseaseSeminars in Liver Disease, 2006
- Transient elastography for diagnosis of advanced fibrosis and portal hypertension in patients with hepatitis C recurrence after liver transplantationLiver Transplantation, 2006
- Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective studyGut, 2006
- Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis CHepatology, 2004
- Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosisGut, 2003
- A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis CHepatology, 2003
- Splenomegaly—an insensitive sign of portal hypertensionAustralian and New Zealand Journal of Medicine, 1990