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Gastroenterology. 2012 Sep;143(3):646-654. doi: 10.1053/j.gastro.2012.05.035. Epub 2012 May 27.

Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis.

Author information

1
Department of Clinical Medicine, University of Bologna, Bologna, Italy. Electronic address: antonio.colecchia@aosp.bo.it.
2
Department of Clinical Medicine, University of Bologna, Bologna, Italy.
3
Department of Cardiology, University of Bologna, Bologna, Italy.
4
Department of Medicine, A. Manzoni Hospital, Lecco, Italy.
5
Department of Clinical Science, University of Milan, Milan, Italy.
6
Department of Pediatrics, University of Modena, Modena, Italy.
7
Department of Internal Medicine, University of Florence, Florence, Italy.
8
Department of Internal Medicine, University of Florence, Florence, Italy; Centre for Research, High Education and Transfer "DENOThe", University of Florence, Florence, Italy.

Abstract

BACKGROUND & AIMS:

The hepatic vein pressure gradient (HVPG) is the standard used to determine the degree of portal hypertension (PH) and an important prognostic factor for patients with cirrhosis; HVPG values correlate with the presence of esophageal varices (EV). However, HVPG can only be accurately determined at specialized centers; noninvasive methods are needed to predict HVPG values and the presence of EV. We compared the diagnostic performance of spleen stiffness (SS) measurement by transient elastography with that of liver stiffness (LS) and of other recently proposed noninvasive tests.

METHODS:

We measured SS and LS in 100 consecutive patients with hepatitis C virus-induced cirrhosis. Patients were also assessed by FibroScan, HVPG, esophagogastroduodenoscopy, and liver biopsy. We also analyzed LS-spleen diameter to platelet ratio score and platelet count to spleen diameter.

RESULTS:

SS and LS were more accurate than other noninvasive parameters in identifying patients with EV and different degrees of PH. A linear model that included SS and LS accurately predicted HVPG values (R(2) = 0.85). The results were internally validated using bootstrap analysis.

CONCLUSIONS:

Measurement of SS can be used for noninvasive assessment and monitoring of PH and to detect EV in patients with hepatitis C virus-induced cirrhosis.

PMID:
22643348
DOI:
10.1053/j.gastro.2012.05.035
[Indexed for MEDLINE]
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