Spleen stiffness measurement using fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patients

Ştefănescu, Horia; Grigorescu, Mircea; Lupşor, M.; Procopeţ, Bogdan; Maniu, Alma; Badea, Radu

doi:10.1111/j.1440-1746.2010.06325.x

Cited by 212 publications

(177 citation statements)

References 29 publications

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“…As reported, spleen stiffness estimated by real-time elastography, 10 FibroScan, 11 and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) on acoustic radiation force impulse imaging [12][13][14][15] can be used for diagnosis of liver fibrosis and portal hypertension and for predicting variceal bleeding. The novel ultrasound-based acoustic radiation force impulse imaging directly estimates tissue stiffness by measuring the speed of shear wave propagation through the tissue in the region of interest (eg, the spleen).…”

mentioning

confidence: 99%

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Gao¹,

Xiao

Zheng

et al. 2016

J of Ultrasound Medicine

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A Pilot Studyhe transjugular intrahepatic portosystemic shunt (TIPS) is used for management of refractory acute variceal hemorrhage and intractable ascites in late-stage liver diseases with portal hypertension. 1 In addition to monitoring the clinical status, it is important to monitor TIPS hemodynamic function objectively. 2,3 Although the portosystemic pressure gradient (PPG) and hepatic venous pressure gradient are still considered the reference standards for diagnosis and monitoring of portal hypertension, they Jing Gao, MD, Xiao Zheng, MS, Yuan-Yi Zheng, MD, Guo-Qing Zuo, MD, Hai-Tao Ran, MD, Yong Ho Auh, MD, Levi Waldron, PhD, Tiffany Chan, MS, Zhi-Gang Wang, MD Received July 6, 2015, Objectives-To assess the feasibility of splenic shear wave elastography in monitoring transjugular intrahepatic portosystemic shunt (TIPS) function.Methods-We measured splenic shear wave velocity (SWV), main portal vein velocity (PVV), and splenic vein velocity (SVV) in 33 patients 1 day before and 3 days to 12 months after TIPS placement. We also measured PVV, SVV, and SWV in 10 of 33 patients with TIPS dysfunction 1 day before and 3 to 6 days after TIPS revision. Analyses included differences in portosystemic pressure gradient (PPG), PVV, SVV, and mean SWV before and after TIPS procedures; comparison of median SWV before and after TIPS procedures; differences in PVV, SVV, and SWV before and at different times up to 12 months after TIPS placement; accuracy of PVV, SVV, and SWV in determining TIPS dysfunction; and correlation between PPG and SWV.Results-During 12 months of follow-up, 23 of 33 patients had functioning TIPS, and 10 had TIPS dysfunction. The median SWV was significantly different before and after primary TIPS placement (3.60 versus 3.05 m/s; P = .005), as well as before and after revision (3.73 versus 3.06 m/s; P = .003). The PPG, PVV, and SVV were also significantly different before and after TIPS placement and revision (P < .001). The PPG and SWV decreased, whereas PVV and SVV increased, after successful TIPS procedures. A positive correlation was observed between PPG and SWV (r = 0.70; P < .001), and a negative correlation was observed between PPG and PVV and SVV (r = -0.65; P < .001). The areas under the receiver operating characteristic curve for PVV, SVV, and SWV in determining TIPS dysfunction were 0.82, 0.84, and 0.81, respectively.Conclusions-Splenic SWV is compatible with splenoportal venous velocity in quantitatively monitoring TIPS function and determining TIPS dysfunction.

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confidence: 99%

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Gao¹,

Xiao

Zheng

et al. 2016

J of Ultrasound Medicine

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“…Liver cirrhosis is the end stage of chronic liver diseases and a kind of severe and irreversible liver disease, especially when decompensate patients suffer from persistent jaundice, refractory ascites, persistent or obviously delayed prothrombin time, and show complications, all prognoses are relatively poor [3]. Currently, there is still a lack of reliable specific therapy for liver cirrhosis, and the treatment emphasizes etiology and general symptomatic treatment to alleviate the condition, extend the compensated stage and maintain the labor force [4].…”

Section: Introductionmentioning

confidence: 99%

Research on Rehabilitation Factors Related to Chinese Senile Liver Cirrhosis based on Hospital Information System

Xiaodong¹,

Jianjun²,

Ganchen³

et al. 2015

IJMUE

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“…The meta-analysis of 12 studies with 1,497 patients found suboptimal diagnostic accuracy of spleen stiffness measurement (SSM) in the detection of oesophageal varices, with a sensitivity and specificity of <80% [29]. Nevertheless, by using both LSM and SSM Stefanescu et al were able to predict the presence of oesophageal varices with accuracy of 89.95% [30]. Recent meta-analysis, which included 16 studies involving 1,892 patients undergoing LSM and SSM, reported a better overall diagnostic accuracy of SSM, compared with LSM, in the diagnosis of the presence (any grade) of oesophageal varices (AUROC 0.88 vs. 0.81, p<0.01).…”

Section: Spleen Elastography In Portal Hypertensionmentioning

confidence: 99%

Non-invasive diagnosis of portal hypertension in cirrhosis using ultrasound based elastography

et al. 2017

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Liver stiffness measurement (LSM) by ultrasound-based elastography may be used to non-invasively discriminate between the stages of liver fibrosis, rule out cirrhosis and follow its evolution, including the prediction of the presence of oesophageal varices. The same is possible in order to diagnose clinically significant portal hypertension, referring primarilyto transient elastography and LSM values ≥20-25 kPa. The same approach may be used to reliably rule out the presence ofoesophageal varices (LSM <20 kPa + platelets >150x109/L). These recommendations refer primarily to patients with viral aetiology of chronic liver disease (hepatitis C), while additional studies are required for other aetiologies. While spleen stiffness measurement (SSM) also poses a logical choice in this indication, controversial results have nevertheless been published on this issue. It should be emphasized, however, that more recent data indicate that this parameter should be included in the diagnostic algorithm for portal hypertension, if not as the sole then as a part of a sequential algorithm, combined with LSM. Until now, transient elastography has been most extensively studied and founded on scientific evidence, although the results of other ultrasound-based elastography techniques demonstrate the same trend for the non-invasive assessment of portal hypertension.

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Spleen stiffness measurement using fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patients

Cited by 212 publications

References 29 publications

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Research on Rehabilitation Factors Related to Chinese Senile Liver Cirrhosis based on Hospital Information System

Non-invasive diagnosis of portal hypertension in cirrhosis using ultrasound based elastography

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