Liver and spleen stiffness in patients with extrahepatic portal vein obstruction

Radiology. 2012 Jun;263(3):893-9. doi: 10.1148/radiol.12111046. Epub 2012 Apr 20.

Abstract

Purpose: To evaluate liver stiffness (LS) and spleen stiffness (SS) in patients with extrahepatic portal vein obstruction (EHPVO).

Materials and methods: Institutional research board approval and informed consent were obtained. LS and SS were measured in 65 consecutive patients with EHPVO. Patients underwent endoscopy, liver biopsy, liver function tests, abdominal ultrasonography, a detailed history, and examination. LS and SS measurements were also obtained in 50 age-matched healthy control subjects. Comparisons were made by using the Student t test, Mann-Whitney test for quantitative data, and χ(2) or Fisher exact test for qualitative data.

Results: Sixty-five patients with EHPVO (with a bleed, n = 45; without a bleed, n = 20; mean age, 25.4 years ± 10.7 [standard deviation]; 29 men, 36 women) were enrolled. Twenty-two (34%) had hypersplenism. LS (P = .001) and SS (P = .01) were higher in patients with EHPVO (6.7 kPa ± 2.3 and 51.7 kPa ± 21.5, respectively) than in control subjects (4.6 kPa ± 0.7 and 16.0 kPa ± 3.0, respectively). Patients who had a bleed had higher SS than did those without a bleed (60.4 kPa ± 5.4 vs 30.3 kPa ± 14.2, P = .01). There was no significant difference in age (26.7 years ± 10.4 vs 22.5 years ± 9.8, P = .8) and median duration of disease (4.5 years [range, 1-26 years] vs 6.0 years [range, 1-22 years], P = .23) in patients with a bleed versus those without. With a cutoff of 5.9 kPa for LS, sensitivity and specificity for detection of a variceal bleed were 67% and 75%, respectively. An SS cutoff of 42.8 kPa yielded sensitivity and specificity of 88% and 94%, respectively.

Conclusion: LS and SS were higher in patients with EHPVO than in control subjects, and patients with a history of a bleed had a higher SS than did those without a bleed.

MeSH terms

  • Adult
  • Biopsy
  • Case-Control Studies
  • Chi-Square Distribution
  • Elasticity
  • Elasticity Imaging Techniques / methods*
  • Endoscopy
  • Humans
  • Liver / diagnostic imaging*
  • Liver / physiopathology*
  • Liver Function Tests
  • Portal Vein / diagnostic imaging*
  • Portal Vein / physiopathology*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spleen / diagnostic imaging*
  • Spleen / physiopathology*
  • Statistics, Nonparametric
  • Vascular Diseases / diagnostic imaging*
  • Vascular Diseases / physiopathology*