Feasibility of In Vivo MR Elastographic Splenic Stiffness Measurements in the Assessment of Portal Hypertension
June 25th, 2009 Posted by: admin
OBJECTIVE. Liver stiffness is associated with portal hypertension in
patients with chronic liver disease. However, the relation between spleen
stiffness and clinically significant portal hypertension remains unknown. The
purposes of this study were to determine the feasibility of measuring spleen
stiffness with MR elastography and to prospectively test the technique in
healthy volunteers and in patients with compensated liver disease.
MATERIALS AND METHODS. Spleen stiffness was measured with MR
elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years)
and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver
disease of various causes. For patients with liver disease, laboratory
findings, spleen size, presence and size of esophageal varices, and liver
histologic results were recorded. Statistical analyses were performed to
assess all measurements.
RESULTS. MR elastography of the spleen was successfully performed on
all volunteers and patients. The mean spleen stiffness was significantly lower
in the volunteers (mean, 3.6 ± 0.3 kPa) than in the patients with liver
fibrosis (mean, 5.6 ± 5.0 kPa; range, 2.7-19.2 kPa; p <
0.001). In addition, a significant correlation was observed between liver
stiffness and spleen stiffness for the entire cohort (r2 =
0.75; p < 0.001). Predictors of spleen stiffness were
splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of
10.5 kPa or greater was identified in all patients with esophageal
varices.
CONCLUSION. MR elastography of the spleen is feasible and shows
promise as a quantitative method for predicting the presence of esophageal
varices in patients with advanced hepatic fibrosis.
