Shear‐wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study

Jansen, Christian; Bogs, Christopher; Verlinden, Wim; Thiele, Maja; Möller, Philipp T.; Görtzen, Jan; Lehmann, Jennifer; Vanwolleghem, Thomas; Vonghia, Luisa; Praktiknjo, Michael; Chang, Johannes; Krag, Aleksander; Strassburg, Christian P.; Francque, Sven; Trebicka, Jonel

doi:10.1111/liv.13243

Cited by 123 publications

(139 citation statements)

References 34 publications

(92 reference statements)

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“…Moreover, the capacity of SS was measured either by tissue elastometry or by ARFI in identifying patients with portal hypertension (i.e., hepatic venous pressure gradient [HVPG] > 10 mmHg); clinically significant portal hypertension (HVPG > 12 mmHg) or varices at endoscopy has been shown to be superior to liver stiffness (LS) although not in all studies . Thus, SS can be considered a promising method for the non‐invasive diagnosis of portal hypertension . However, little is known on the relationship between the modification of the portal pressure and the modification of splenic stiffness.…”

Section: Introductionmentioning

confidence: 99%

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

Santis

Nardelli

Bassanelli

et al. 2018

J of Gastro and Hepatol

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Section: Introductionmentioning

confidence: 99%

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

Santis

Nardelli

Bassanelli

et al. 2018

J of Gastro and Hepatol

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“…Spleen stiffness is proposed as a marker of clinically significant portal hypertension and esophageal varices [9, 10] and controlled attenuation parameter (CAP) is a novel non-invasive marker of liver steatosis. [11] All these techniques are based on the physical properties of the liver and spleen, which might be confounded by factors other than fibrosis or steatosis.…”

Section: Introductionmentioning

confidence: 99%

High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal

et al. 2017

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Food intake increases liver stiffness, but it is believed that liver stiffness returns to baseline two hours after a meal. The aim of this study was to investigate the impact of different sized meals on liver stiffness. Liver and spleen stiffness was measured with transient elastography (TE) and real-time 2-dimensional shear wave elastography (2D-SWE). Patients ingested a 625 kcal and a 1250 kcal liquid meal on two consecutive days. We measured liver and spleen elasticity, Controlled attenuation parameter (CAP) and portal flow at baseline and after 20, 40, 60, 120 and 180 minutes. Sixty patients participated, 83% with alcoholic liver disease. Twenty-eight patients had METAVIR fibrosis score F0-3 and 32 patients had cirrhosis. Liver stiffness, spleen stiffness and CAP increased after both meals for all stages of fibrosis. False positive 2D-SWE liver stiffness measurements caused 36% and 52% of patients with F0-3 fibrosis to be misclassified with higher stages of fibrosis after the moderate and high caloric meal. Likewise, 10% and 13% of compensated cirrhosis patients were misclassified with clinically significant portal hypertension after the two meals. We observed similar misclassification rates with TE. After three hours, liver stiffness remained elevated more than 20% from baseline in up to 50% of patients. In conclusion: Liver stiffness, spleen stiffness and CAP increase after a meal across all stages of fibrosis and across elastography techniques. Up to half of patients may be misclassified with higher stages of fibrosis, if they are assessed after less than three hours fasting period.

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“…Furthermore, liver biopsy is limited by serious complications[23,24], sampling errors[25], and both inter-pathologist and intra-pathologist variability[26]. Shear wave elastography, a reliable, rapid and non-invasive technique, has been used to evaluate tissue stiffness for many years and is increasingly important in the diagnosis of liver fibrosis[27-29]. Furthermore, an acoustic radiation force impulse (ARFI) technique, elastography point quantification (ElastPQ)[30], has been developed to measure the tissue[31-34].…”

Section: Introductionmentioning

confidence: 99%

Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl₄-induced liver fibrosis

Wang¹,

Ling²,

Hong³

et al. 2016

WJG

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AIMTo investigate the diagnostic performance of liver stiffness measurement (LSM) by elastography point quantification (ElastPQ) in animal models and determine the longitudinal changes in liver stiffness by ElastPQ after splenectomy at different stages of fibrosis.METHODSLiver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by ElastPQ. Liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by ElastPQ and liver function according to blood tests.RESULTSLSM by ElastPQ was significantly correlated with histologic fibrosis stage (r = 0.85, P < 0.001). The optimal cutoff values by ElastPQ were 11.27, 14.89, and 18.21 kPa for predicting minimal fibrosis, moderate fibrosis, and cirrhosis, respectively. Longitudinal monitoring of the changes in liver stiffness by ElastPQ showed that early splenectomy (especially F1) may delay liver fibrosis progression.CONCLUSIONElastPQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using ElastPQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.

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Shear‐wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study

Cited by 123 publications

References 34 publications

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal

Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl₄-induced liver fibrosis

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Shear‐wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study

Cited by 123 publications

References 34 publications

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt

High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal

Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl4-induced liver fibrosis

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Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl₄-induced liver fibrosis