Spleen Stiffness in Patients With Cirrhosis in Predicting Esophageal Varices

Sharma, Praveen; Kirnake, Vijender; Tyagi, Pankaj; Bansal, Naresh; Singla, Vikas; Kumar, Ashish; Arora, Anil

doi:10.1038/ajg.2013.119

Cited by 182 publications

(133 citation statements)

References 24 publications

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“…As discussed earlier, spleen stiffness may be a marker for portal hypertension. In addition, spleen stiffness may be a predictor of esophageal varices and bleeding risk (76,77). In patients with hemochromatosis, an algorithm that uses serum ferritin levels together with transient elastography was shown to accurately determine the presence of severe fibrosis in 61% of patients, obviating the need for liver biopsy in this group (78).…”

Section: Liver Elastography: Future Directionsmentioning

confidence: 99%

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Babu¹,

Wells²,

Teytelboym³

et al. 2016

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100

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Section: Liver Elastography: Future Directionsmentioning

confidence: 99%

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Babu¹,

Wells²,

Teytelboym³

et al. 2016

RadioGraphics

165

100

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“…This could result in poor reliability in a subsequent follow-up study. Additionally, its unreliable rate is relatively higher, as compared with Fibroscan, in which the inconclusive measurement rates were reported to be 14.3% [23] and 13% [24].…”

Section: Discussionmentioning

confidence: 99%

Is the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology predictive of the presence of esophageal varices in patients with cirrhosis of various etiologies?

Park¹,

Kwon²,

Cho³

et al. 2016

Med Ultrason

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Aim: This study's aim was to determine the accuracy of the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology, to predict the presence of esophageal varices (EVs) in patients with liver cirrhosis of various etiologies. Material and methods: Of the 366 enrolled patients, 192 had hepatitis B virus, 74 had hepatitis C virus, and 100 had alcohol-related cirrhosis. All patients underwent biochemical tests, gastrointestinal endoscopy, and liver and spleen elastography by ARFI. We evaluated the correlation between the presence of EVs and factors including liver and spleen stiffness measured by ARFI, biochemical tests, and other noninvasive measurements, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count (PLT), spleen diameter (SD), PLT to SD ratio, AST to ALT ratio (AAR) score, the AST to PLT ratio index (APRI) score. Result: A univariate analysis revealed that the AAR score, APRI score, PLT, PLT/SD ratio, and spleen elastography variables were all independently associated with EVs (p<0.05). On multivariate analysis, only spleen elastography was associated with EVs (p=0.001). However, in cases of alcohol-induced liver cirrhosis, spleen stiffness was not reliable for the prediction of EVs. Conclusion: Spleen elastography measured using ARFI may serve as a non-invasive method for determining the presence of EVs. However, it is not an appropriate predictor for EVs in alcoholic cirrhosis.

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“…Similarly, Liu et al (18) , Sharma et al (19) and Fraquelli et al (20) suggested a superiority of SSM in detection of EV in comparison to LSM. Also, Colecchia et al (10) concluded that SSM and LSM were more accurate than other non-invasive parameters in identifying patients with EV.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Liver and Spleen Stiffness by Fibroscan in Comparison to other Validated Indices for Non-Invasive Assessment of Esophageal Varices in Egyptian Patients with HCV-Related Cirrhosis

2016

Int. J. Adv. Res. Biol. Sci.

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Background and Aim: Several investigators have devised non-invasive predictors for presence of esophageal varices (EV) in cirrhotic patients, thus avoiding unnecessary endoscopic screening. This work aimed at evaluating the role of liver and spleen stiffness measurements by Fibroscan in comparison to other validated indices for non-invasive assessment of EV in Egyptian patients with HCV-related cirrhosis. Methods and Material: This cross-sectional study included sixty patients with HCV-related cirrhosis who underwent complete clinical evaluation, laboratory investigations, abdominal ultrasonography, liver and spleen stiffness measurements (LSM and SSM) using Fibroscan and upper gastrointestinal endoscopy. Also, non-invasive predictive scores were calculated: AST-to-ALT ratio (AAR), platelet count/spleen diameter ratio (PSR) and AST-to-platelet ratio index (APRI). The diagnostic performance of each parameter was assessed using receiver operating characteristic (ROC) curves. Results: Patients were classified into two groups; Group 1: 33 patients (55%) with EV, and Group 2: 27 patients (45%) with no EV. There was a highly significant difference between the two groups regarding spleen diameter, PSR, APRI, LSM and SSM (P < 0.01). SSM showed a good performance as regards EV detection in comparison to LSM. At cut-off value ≥ 29 for SSM, sensitivity was 94.4%, specificity 86.4%, PPV 85% and NPV 95% (AUROC 0.934). Conclusion: Spleen stiffness measurement is a sensitive and reliable tool for detection of EV.

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Spleen Stiffness in Patients With Cirrhosis in Predicting Esophageal Varices

Abstract: Measurement of SS can be used for noninvasive assessment of EV and can differentiate large vs. small varices and nonbleeder vs. bleeder.

Cited by 182 publications

References 24 publications

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Is the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology predictive of the presence of esophageal varices in patients with cirrhosis of various etiologies?

Measurement of Liver and Spleen Stiffness by Fibroscan in Comparison to other Validated Indices for Non-Invasive Assessment of Esophageal Varices in Egyptian Patients with HCV-Related Cirrhosis

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