Association of splenic MR elastographic findings with gastroesophageal varices in patients with chronic liver disease

J Magn Reson Imaging. 2015 Jan;41(1):117-24. doi: 10.1002/jmri.24505. Epub 2013 Nov 14.

Abstract

Purpose: To identify magnetic resonance imaging (MRI)-based parameters associated with gastroesophageal varices (GEVs) in patients with chronic liver disease.

Materials and methods: Ninety-three patients were divided into three groups based on endoscopic findings: group 1 with no GEVs (n = 49), group 2 with mild GEVs (n = 30), and group 3 with severe GEVs (n = 14). We used a multivariate logistic regression analysis to assess liver stiffness, aspartate aminotransferase-to-platelet ratio index, spleen stiffness and volume, portal vein velocity, cross-sectional area, and flow volumes potential independent associators of any (mild and severe) GEVs or severe GEVs.

Results: The analysis showed that spleen and liver stiffness and spleen volume were independently associated with any GEVs (spleen stiffness, odds ratio [95% confidence interval], 1.25 [1.04-1.68], P = 0.018; liver stiffness, 1.52 [1.13-2.17], P = 0.006; spleen volume, 1.01 [1.00-1.01], P = 0.016), whereas spleen stiffness was associated with severe GEVs (1.82 [1.25-2.95]; P = 0.005).

Conclusion: Liver and spleen stiffness and spleen volume are associated with GEVs in patients with chronic liver disease. Compared with liver stiffness and spleen volume, spleen stiffness is more strongly associated with severe GEVs.

Keywords: MR elastography; liver cirrhosis; phase-contrast MRI; portal hypertension; spleen stiffness.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Elasticity Imaging Techniques / methods*
  • Esophageal and Gastric Varices / complications*
  • Esophageal and Gastric Varices / pathology
  • Female
  • Humans
  • Liver / pathology
  • Liver Diseases / complications*
  • Liver Diseases / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index
  • Spleen / pathology*