Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension

Abstract

AIMTo explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension, and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.METHODSAll 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore, 67 patients were followed-up at 20 mo after treatment, and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1st week, 3rd month and 9th month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group, while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile, in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension, Cox’s proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic (ROC) curves.RESULTSThe liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline, while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore, liver and spleen shear wave velocity was higher in the unfavorable prognosis group, compared with the favorable prognosis group; the differences were statistically significant (P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3rd month after treatment [relative risk (RR) = 3.481]. At the 9th month after treatment, the prognosis was affected by liver hardness (RR = 5.241) and spleen hardness (RR = 7.829). The differences between these two groups were statistically significant (P < 0.05). The ROC analysis revealed that the area under the curve (AUC) of spleen hardness at the 3rd month after treatment was 0.644, while the AUCs of liver and spleen hardness at the 9th month were 0.579 and 0.776, respectively. These might predict the prognosis of patients with portal hypertension.CONCLUSIONSpleen hardness at the 3rd month and liver and spleen shear wave velocity at the 9th month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.

Comparative Efficacy of Ultrasonography and Acoustic Radiation Force Impulse (ARFI) Elastography in Prediction of Malignancy in Thyroid Nodules

“…Now it is possible to assess, in advance, the velocities in different tissues by comparing to normal controls based on large sample sizes (e.g., the cutoff value in case of a normal liver is 3.0 m/s, and normal thyroid is <2 m/s). 14,15 In the present study, a total of 141 nodules were imaged; 12 (8.5%) were found malignant, and 129 (91.5%) nodules were classified benign. Among the malignant nodules, papillary carcinoma was most common, whereas colloid goiter accounted for the majority of the benign nodules.…”

“…Now it is possible to assess, in advance, the velocities in different tissues by comparing to normal controls based on large sample sizes (e.g., the cutoff value in case of a normal liver is 3.0 m/s, and normal thyroid is <2 m/s). 14,15…”

Our experience with liver and spleen elastography in the prediction of oesophageal varices

“… 31 , 32 Similarly, some authors also found that LS can predict the presence of poor prognostic factors such as EV in patients with liver cirrhosis. 27 , 33 …”

In situ subtotal spleen resection combined with selective pericardial devascularization for the treatment of portal hypertension

“…With further understanding of spleen anatomy and its immune function, increasing attention has recently been given to spleen preservation operations. Recent studies have shown that the spleen plays an important role in hepatic function protection, infection control, and tumor immunity in patients with PHT[ 2 ]. Total splenectomy in patients with liver cirrhosis reduces the ability of the body to remove particulate matter from the blood and aggravate immune dysfunction.…”