A Primer to the Diagnostic and Clinical Utility of Spleen Stiffness Measurement in Patients With Chronic Liver Disease

Abstract

Patients with chronic liver disease (CLD) may present with varying severities of liver fibrosis. Fortunately, noninvasive testing with liver elastography is now widely available. It has changed our approach to staging liver disease, providing an opportunity to detect the presence of compensated advanced CLD (cACLD). 1,2 Nevertheless, noninvasive prognosis in cACLD, particularly those with cirrhosis and portal hypertension (PH), remains imperfect. For example, the rate of decompensation (variceal bleed, hepatic encephalopathy, or ascites) in patients with NASH cirrhosis varied significantly from 3% to 19% in two recent phase 3 trials. 3,4 This observation indicates that new tools are needed to improve the prediction of clinical progression from a compensated to decompensated state in cACLD.

Spleen stiffness measurement as a non-invasive assessment in patients with portal hypertension

“…There are four main different types of elastography, for example, transient elastography (TE), shear wave elastography (SWE), acoustic radiation force impulse (ARFI) and magnetic resonance elastography (MRE). 11 Owing to the fact that the spleen has intrinsic elastic properties, 12 SS evaluation with elastography requires determination of normal reference interval for healthy individuals. Table 1 provides a detailed information of different techniques that are currently available for SSM and measurements in healthy subjects.…”