Liver Stiffness Assessed by Real-Time Two-dimensional Shear Wave Elastography Predicts Hypersplenism in Patients with Wilson’s Disease: A Prospective Study

Abstract

Background To explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE）in predicting the occurrence of hypersplenism in patients diagnosed with Wilson’s disease (WD). Methods A total of 90 WD patients were enrolled in this prospective study between May 2018 and December 2018. Clinical data and ultrasound imaging including 2D-SWE liver stiffness of WD patients as baseline data were collected. Patients were followed up for 24 months, or patients developed hypersplenism after enrollment. Risk factors for hypersplenism were determined using cox regression and receiver operating characteristic curve. Results Twenty-night (32.2%) patients were found developed hypersplenism. The age, the diameter of portal vein, and the liver stiffness were independent risk factors associated with hypersplenism in WD. The cutoff value of liver stiffness for predicting hypersplenism was 10.45 kPa, with sensitivity and specificity of 75.9% and 73.8%, respectively. When patients were divided into two groups according to liver stiffness ≥10.45 kPa or <10.45 kPa, the incidence of hypersplenism were 57.9% vs. 13.5% (P<0.001), and the median time between the enrollment and the development of hypersplenism was 15 months vs. 22 months (P<0.001) for the two groups, respectively. Conclusion The liver stiffness measured by 2D-SWE was a reliable predictor of hypersplenism in WD patients. Dynamic monitoring WD patients using 2D-SWE is crucial for the early diagnosis of hypersplenism.

Liver cirrhosis prediction for patients with Wilson disease based on machine learning: a case–control study from southwest China

“…Moreover, the predictive model is moderate, with an accuracy of 0.58 [13]. Wang et al found that liver stiffness evaluated by two-dimensional real-time shear wave elastography, whose inflection point was 10.45 kPa, could predict the occurrence of hypersplenism [14]. Another study found that acoustic radiation force impulse and fibrosis-4 could be used to distinguish cirrhosis in patients with WD, which could partly replace liver biopsy [15].…”