Splenic Elasticity Measured with Real-time Tissue Elastography Is a Marker of Portal Hypertension

Hirooka, Masashi; Ochi, Hironori; Koizumi, Yohei; Kisaka, Yoshiyasu; Abe, Masanori; Ikeda, Yoshio; Matsuura, Bunzo; Hiasa, Yoichi; Onji, Morikazu

doi:10.1148/radiol.11110156

Cited by 87 publications

(70 citation statements)

References 31 publications

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“…Mendes et al (7) reported that portal hypertension could occur in some patients with NAFLD who show only mild or no fibrosis. Evaluation of splenic elasticity is superior to other methods for the estimation of portal hypertension (8). Portal hypertension, as measured according to splenic elasticity, has been reported (9) to occur in patients with NAFLD who have milder fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…The hepatic or splenic elastic ratio (elasticity of small veins and elasticity of hepatic or splenic parenchyma) was then calculated. The means of five measurements were calculated as described elsewhere (8,19). Splenic elasticity has been reported to correlate well with the hepatic venous pressure gradient (HVPG), and this value was termed the splenic elasticity for portal hypertension (SEP) score (splenic elasticity times, 1.63-2.88; r = 0.854; P , .0001) (8,9).…”

Section: Patientsmentioning

confidence: 99%

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Nonalcoholic Fatty Liver Disease: Portal Hypertension Due to Outflow Block in Patients without Cirrhosis

Hirooka¹,

Miyake²,

Ochi³

et al. 2015

Radiology

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease: Portal Hypertension Due to Outflow Block in Patients without Cirrhosis

Hirooka¹,

Miyake²,

Ochi³

et al. 2015

Radiology

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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).…”

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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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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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“…The deformability of the organ (elasticity) depends on the tissue composition; neoplastic tissues have higher cell density and therefore a reduced elasticity (increased tissue stiffness) (Goddi et al, 2012). Similarly, fluids, physically, cannot be compressed and an increased blood flow in an organ increases its hardness (Hirooka et al, 2011). In human medicine, malignant parenchymal lesions are significantly stiffer than surrounding normal parenchyma (Wells & Liang, 2011;Barr, 2012;Teng et al, 2012;Wang et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Role of strain elastography in differentiating malignant hypoechoic splenic lesions in dogs: Preliminary results

Barella¹,

Faverzani²

2017

BJVM

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SummaryBarella, G., M. Lodi & S. Faverzani, 2017. Role of strain elastography in differentiating malignant hypoechoic splenic lesions in dogs: Preliminary results. Bulg. J. Vet. Med., 20, No 3,[255][256][257][258][259][260][261][262][263] This study aims to assess the repeatability and reproducibility of strain elastography in the evaluation of splenic nodules and to verify if it can differentiate benign from malignant splenic lesions in dogs. Twenty-four dogs with a single splenic hypoechoic lesion, underwent strain elastosonography. The strain ratio (SR) and hardness value (HV) were calculated. Repeatability and reproducibility were assessed by the coefficient of variability (CV) and the K of Cohen respectively. ANOVA and Fisher exact test verified the differences between the SR values and HV of benign versus malignant lesions. The odds ratio was also calculated. The SR and HV of benign lesions were different from those of malignant lesions (P<0.05). Malignant lesions tended to have a SR≥1.5 (P=0.0003) and an HV ≥ 70% (P=0.001). The correlation between SR≥1.5 and malignancy was significant (OR, 80.6; P=0.0067) as the one between HV ≥ 70% and malignancy (OR, 47.22; P=0.013). This technique was repeatable and reproducible (CV 0.08±0.03 and K=1 for the SR; CV 0.08±0.05 and K=0.66 for the HV). Elastosonography can differentiate malignant from benign canine hypoechoic splenic lesions.

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Splenic Elasticity Measured with Real-time Tissue Elastography Is a Marker of Portal Hypertension

Abstract: Splenic elasticity determined with RTE is the most closely associated parameter for evaluating HVPG and is useful as a clinical marker of portal hypertension and a predictive marker of gastroesophageal varices.

Cited by 87 publications

References 31 publications

Nonalcoholic Fatty Liver Disease: Portal Hypertension Due to Outflow Block in Patients without Cirrhosis

Nonalcoholic Fatty Liver Disease: Portal Hypertension Due to Outflow Block in Patients without Cirrhosis

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

Role of strain elastography in differentiating malignant hypoechoic splenic lesions in dogs: Preliminary results

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