Purpose To measure spleen stiffness by shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) in patients with splenomegaly and to evaluate utility of elastography technique in identifying etiology of splenomegaly. Methods Sixty-one treatment-naïve patients with splenomegaly were enrolled. The control group consisted of 20 healthy subjects without history of any disease including diabetes and hypertension, alcohol consumption, or biochemical or ultrasonographic findings indicating hepatic and renal diseases. B-mode ultrasonography and elastographic examinations were performed by a radiologist blinded to the participants. Spleen stiffness was measured by SWE using ARFI. Shear wave velocity (SWV) values were given in m/s. Results Splenomegaly patients were assigned into three groups according to their etiologies as hepatoportal (n = 21), myeloproliferative (n = 23), and infectious (n = 17). Splenomegaly groups and control group were comparable regarding age and sex. Spleen size was higher in the splenomegaly groups than in the controls. Median SWV was significantly higher in the hepatoportal (3.85 m/s) and myeloproliferative (3.42 m/s) groups than in the infectious (2.66 m/s) and control (2.22 m/s) groups. The correlation between SWV and spleen size was not significant in any of the groups. The cut-off value was 3.42 (sensitivity 80.9%, specificity 56.5%) in distinguishing hepatoportal from myeloproliferative etiology; 3.02 (sensitivity 100%, specificity 100%) in distinguishing hepatoportal from infectious etiology; and 2.84 (sensitivity 91.3%, specificity 88.2%) in distinguishing myeloproliferative from infectious etiology. Conclusion Spleen stiffness measured by elastographic techniques in splenomegaly patients was higher than that in healthy subjects. SWV appeared to be beneficial in predicting the etiology of splenomegaly.

ObjectivesChronic dialysis causes changes in the structure of median nerve. This is a risk for the development of carpal tunnel syndrome in patients on dialysis. The aim of the present study was to evaluate the diagnostic capacity of shear wave velocity (SWV) and the cross‐sectional area (CSA) to detect the structural changes of the median nerve in patients with end‐stage chronic kidney disease on hemodialysis.MethodsTwenty‐five patients with chronic kidney disease undergoing hemodialysis 3 times per week and 26 healthy controls were included. None of the participants had any signs or symptoms of carpal tunnel syndrome specified according to the criteria of the American Academy of Neurology Practice Parameters. Both patients and controls underwent sonographic and elastographic examinations of the median nerves in both hands to evaluate CSA and SWV values, and they were compared regarding these parameters.ResultsThe mean CSA of the median nerve in the chronic hemodialysis group was significantly higher than that in the control group (12.74 ± 1.88 mm2 versus 8.89 ± 1.45 mm2; P < .001). The mean longitudinal and axial SWV values in the hemodialysis group (3.86 ± 0.54 m/s and 3.92 ± 0.52 m/s, respectively) were significantly higher than those in the control group (2.98 ± 0.31 m/s and 3.04 ± 0.31 m/s, respectively; P < .001).ConclusionsPatients on chronic hemodialysis had higher mean CSA and SWV values of the median nerve compared with the healthy controls. Structural changes in the median nerve that occur in patients on chronic hemodialysis can be detected by shear‐wave sonoelastography.