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Articles de revues sur le sujet « Portal hypertension, spleen stiffness »

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Auteur : Grafiati
Publié le 10 mars 2023

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1

Yuldashev, Rustam Z., Makhmud M. Aliev, Shoilkhom I. Shokhaydarov et Dilnoza B. Tursunova. « Non-invasive diagnostics of extrahepatic portal hypertension in children ». Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 12, no 1 (12 avril 2022) : 41–50. http://dx.doi.org/10.17816/psaic1011.

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BACKGROUND: The primary method for diagnosing gastroesophageal bleeding in varicose veins of the esophagus and stomach in children is fibroesophagogastroduodenoscopy. This study investigates the possibilities of 2D shear wave elastography stiffness of the spleen to determine esophageal varicose veins in children with extrahepatic portal hypertension. MATERIALS AND METHODS: A retrospective analysis of the effectiveness of the method of two-dimensional elastography by shear wave stiffness of the spleen was conducted in children with extrahepatic portal hypertension in 39 children (main group) and 11 healthy children (control group). All patients initially underwent fibroesophagogastroduodenoscopy followed by ultrasound, including 2D shear wave stiffness elastography of the spleen. Spleen stiffness was then compared with clinical symptoms, the degree of esophageal varices, and other sonographic parameters. RESULTS: According to elastography data, the spleen stiffness index in children with extrahepatic portal hypertension was 43.98 3.8 kPa, significantly higher than in the control group children (p = 0.006). Spleen stiffness measurements significantly correlated with the degree of esophageal varices in children with extrahepatic portal hypertension (r = 0.57, p = 0.0002). According to the endoscopy results in seven patients after vascular bypass surgery, esophageal varicose veins were not detected. Nevertheless, spleen stiffness in these children remained significantly higher than in the control group (27 3.9 kPa and 18 1.2 kPa, respectively, p = 0.05). CONCLUSIONS: The study results indicate that 2D stiffness shear wave elastography of the spleen effectively assesses esophageal varices in children with extrahepatic portal hypertension. This method is also convenient to monitor the reduction of varicose veins after surgical treatment and is a possible alternative to endoscopy, especially in young children.
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Binzberger, Andreas, Mark Hänle, Matthias Pfahler, Wolfgang Kratzer, Thomas Seufferlein et Eugen Zizer. « Spleen and Liver Stiffness Evaluation by ARFI Imaging : A Reliable Tool for a Short-Term Monitoring of Portal Hypertension ? » International Journal of Hepatology 2022 (9 septembre 2022) : 1–14. http://dx.doi.org/10.1155/2022/7384144.

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Background. Assessment of hepatic venous pressure gradient (HVPG) is the most reliable, though invasive method for evaluation of portal hypertension. Non-invasive, elastography-based techniques are well established in diagnosis, but not in monitoring of portal hypertension. The aim of our prospective study was to determine the value of acoustic radiation force impulse (ARFI) elastography technique of the liver and spleen in diagnosis and monitoring of portal hypertension. Methods. We prospectively assessed portal hypertension by HVPG and corresponding elastography of the liver and spleen in 31 patients with liver cirrhosis and an indication for primary prophylaxis by non-cardio selective beta-blockers. Investigations were performed at baseline and a follow-up visit after 6-8 weeks. To address the known large variability of values for spleen elastography, well-defined corresponding areas in the spleen were used for baseline and follow-up elastography. Sensitivity, specificity, and AUC-ROC values for both spleen and liver elastography monitoring of portal hypertension were calculated. Results. Liver but not spleen elastography significantly correlated with HVPG results and was suitable for initial evaluation of portal hypertension. However, changes in HVPG results did not show any correlation with alterations of ARFI values from baseline to follow-up visits both for liver and spleen elastography. Spleen stiffness results were not homogeneous across the whole organ differing significantly between the upper, hilar, and bottom placed investigation areas. Conclusions. In this prospective study ARFI-based assessment of liver elastography showed itself suitable for initial assessment but not for monitoring of portal hypertension. Spleen elastography was not appropriate for both, evaluation and monitoring of portal hypertension. A possible explanation for this new data that are in some contrast to previously published results is the degree of portal hypertension in our study, a comparatively short follow-up period, and well-defined investigation areas for spleen elastography in repetitive ARFI investigations. This trial is registered with NCT03315767.
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Franková, Soňa, et Jan Šperl. « Non-invasive methods in the assessment of portal hypertension severity ». Gastroenterologie a hepatologie 75, no 2 (30 avril 2021) : 125–33. http://dx.doi.org/10.48095/ccgh2021125.

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Portal hypertension represents a wide spectrum of complications of chronic liver diseases and may present by ascites, oesophageal varices, splenomegaly, hypersplenism, hepatorenal and hepatopulmonary syndrome or portopulmonary hypertension. Portal hypertension and its severity predicts the patient‘s prognosis: as an invasive technique, the portosystemic gradient (HPVG – hepatic venous pressure gradient) measurement by hepatic veins catheterisation has remained the gold standard of its assessment. A reliable, non-invasive method to assess the severity of portal hypertension is of paramount importance; the patients with clinically significant portal hypertension have a high risk of variceal bleeding and higher mortality. Recently, non-invasive methods enabling the assessment of liver stiffness have been introduced into clinical practice in hepatology. Not only may these methods substitute for liver biopsy, but they may also be used to assess the degree of liver fibrosis and predict the severity of portal hypertension. Nowadays, we can use the quantitative elastography (transient elastography, point shear-wave elastrography, 2D-shear-wave elastography) or magnetic resonance imaging. We may also assess the severity of portal hypertension based on the non-invasive markers of liver fibrosis (i.e. ELF test) or estimate clinically signifi cant portal hypertension using composite scores (LSPS – liver spleen stiff ness score), based on liver stiffness value, spleen diameter and platelet count. Spleen stiffness measurement is a new method that needs further prospective studies. The review describes current possibilities of the non-invasive assessment of portal hypertension and its severity.
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Morozov, S. V., et V. А. Izranov. « Comparsion of Liver and Spleen Elastometry Features ». Journal of radiology and nuclear medicine 102, no 4 (15 septembre 2021) : 247–54. http://dx.doi.org/10.20862/0042-4676-2021-102-4-247-254.

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The review presents data on the comparison of the features of liver and spleen stiffness measurements and those on the impact of various conditions on the measurement results (the type of a sensor used, food intake, number of measurements, patient position, breathing phase, etc.). Literature has been sought in the PubMed and eLibrary databases. In particular, the liver and spleen stiffness values vary differently at the height of inspiration and expiration. This is due to organ engorgement with a change in intrathoracic and intraabdominal pressures, as well as to a reduction in splenic arterial flow during exhalation. The review gives published data on liver and spleen stiffness values in healthy volunteers. The spleen is a stiffer organ than the liver. The different liver and spleen stiffness is explained by the features of blood supply (the spleen receives the most blood supply from the intensive-flow artery; the liver does from the portal vein). The reasons for increasing the stiffness of these organs in both health and disease are described. Estimation of liver stiffness can be used to diagnose cirrhosis and portal hypertension. That of spleen stiffness can help in the diagnosis of portal hypertension and in the indirect diagnosis of the presence of esophageal varices and the nature of a splenic lesion.
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Robles-Medranda, Carlos, Roberto Oleas, Miguel Puga-Tejada, Manuel Valero, Raquel Del Valle, Jesenia Ospina et Hannah Pitanga-Lukashok. « Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease ». Endoscopy International Open 08, no 11 (22 octobre 2020) : E1623—E1632. http://dx.doi.org/10.1055/a-1233-1934.

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Abstract Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.
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Stefanescu, Horia, Bogdan Procopet, Monica Platon-Lupsor et Christophe Bureau. « Is There Any Place for Spleen Stiffness Measurement in Portal Hypertension ? » American Journal of Gastroenterology 108, no 10 (octobre 2013) : 1660–61. http://dx.doi.org/10.1038/ajg.2013.239.

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Thiele, M., et A. Krag. « Editorial : the portal hypertension puzzle-spleen stiffness evades validation as non-invasive marker of clinically significant portal hypertension ». Alimentary Pharmacology & ; Therapeutics 47, no 6 (15 février 2018) : 856–57. http://dx.doi.org/10.1111/apt.14536.

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Takuma, Yoshitaka, Kazuhiro Nouso, Youichi Morimoto, Junko Tomokuni, Akiko Sahara, Hiroyuki Takabatake, Kazuhiro Matsueda et Hiroshi Yamamoto. « Portal Hypertension in Patients with Liver Cirrhosis : Diagnostic Accuracy of Spleen Stiffness ». Radiology 279, no 2 (mai 2016) : 609–19. http://dx.doi.org/10.1148/radiol.2015150690.

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Goldschmidt, Imeke, Catharina Brauch, Thierry Poynard et Ulrich Baumann. « Spleen Stiffness Measurement by Transient Elastography to Diagnose Portal Hypertension in Children ». Journal of Pediatric Gastroenterology and Nutrition 59, no 2 (août 2014) : 197–203. http://dx.doi.org/10.1097/mpg.0000000000000400.

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Chin, Jun Liong, Grace Chan et P. Aiden McCormick. « Spleen Stiffness : The New Kid on the Block for Diagnosing Portal Hypertension ? » Gastroenterology 144, no 5 (mai 2013) : 1152–53. http://dx.doi.org/10.1053/j.gastro.2013.02.047.

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Cunningham, Morven E., Gilda Parastandeh-Chehr, Orlando Cerocchi, David K. Wong et Keyur Patel. « Noninvasive Predictors of High-Risk Varices in Patients with Non-Cirrhotic Portal Hypertension ». Canadian Journal of Gastroenterology and Hepatology 2019 (7 février 2019) : 1–7. http://dx.doi.org/10.1155/2019/1808797.

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Non-cirrhotic portal hypertension (NCPH) comprises a heterogeneous group of liver disorders causing portal hypertension without cirrhosis and carries a high risk of variceal bleeding. Recent guidelines, based largely on patients with viral cirrhosis, suggest low likelihood of high risk varices (HRV) in patients with a liver stiffness measurement (LSM) <20 kPa and platelet count >150 × 109/L. In NCPH, LSM is often higher than healthy controls but lower than matched cirrhotic patients. The aim of this study was to assess whether LSM or other noninvasive assessments of portal hypertension could predict HRV in NCPH patients. Methods. Records of patients with NCPH seen at a single centre between 2007 and 2018 were reviewed retrospectively. Primary outcome measure was presence or absence of HRV at gastroscopy within 12 months of clinical assessment. Association of LSM or other clinical features of portal hypertension (spleen size, platelet count, platelet count/spleen length ratio (PSL), LSM-spleen length/platelet count ratio score (LSP)) with HRV and ability of these variables to predict HRV was analysed. Results. Of 44 patients with NCPH who met inclusion criteria, 34% (15/44) had HRV. In a multivariate model, spleen size and PSL correlated with HRV but platelet count, LSM, and LSP did not (spleen size: β = 0.35, p = 0.02; OR 1.42, 95% CI 1.06-1.92; PSL: β = -1.47, p = 0.02; OR 0.23, 95% CI 0.07-0.80). There was no significant difference between spleen size and PSL in predicting HRV (AUROC 0.81 (95% CI 0.66 – 0.91) versus 0.71 (95% CI 0.54 – 0.84), respectively, p = 0.400). Spleen size >17.2cm had sensitivity 78.6% and specificity 64.3% for prediction of HRV. Conclusions. In NCPH patients, spleen size may predict risk of HRV at gastroscopy within 12 months. LSM and platelet count are not useful to assess risk of HRV in NCPH.
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Sugio, Ryo, Yoshiyuki Sawai, Kazuto Fukuda, Takumi Igura, Sachiyo Kogita, Masahiro Ichihi, Yasushi Seki, Norihiko Fujita, Masahide Oshita et Yasuharu Imai. « Changes in Liver and Splenic Stiffness after Direct-Acting Antiviral Therapy in Chronic Hepatitis C : A Single-Centre, Prospective, Observational Study ». GastroHep 2022 (19 décembre 2022) : 1–8. http://dx.doi.org/10.1155/2022/1374410.

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Background. Liver and spleen stiffness measured by shear-wave elastography have been demonstrated to correlate well with liver fibrosis and hepatic venous pressure gradient, respectively. Aim. To investigate the long-term effect of direct-acting antivirals (DAA) on liver and splenic stiffness in patients with chronic hepatitis C. Methods. We conducted a single-centre prospective observational study including 129 chronic hepatitis C patients who achieved a sustained virological response (SVR) with DAA treatment. Liver and spleen stiffness were measured by point shear-wave elastography at pretreatment, end of treatment (EOT), and 48 and 96 weeks after EOT (SVR48 and SVR96, respectively). Results. Liver stiffness measurements (LSM) continued to decline to SVR96, whereas there was no change in spleen stiffness measurements (SSM). Stratified analysis at the SSM 3.2 m/s, which was estimated as the cut-off value of clinically significant portal hypertension, showed that SSM did not change in the low SSM group (SSM <3.2 m/s, n =81), whereas in the high SSM group (SSM ≥3.2 m/s, n =48), the SSM decreased significantly between pretreatment and EOT but did not change thereafter. Moreover, multivariate analysis of risk factors for the SSM remaining in the range of SSM ≥3.2 m/s at SVR96 in the high SSM group revealed that LSM ≥1.93 m/s was a significant factor (p =0.019). Conclusion. These results suggest that DAA treatment of chronic hepatitis C patients may improve liver fibrosis in the long term and some patients with advanced liver fibrosis may not expect an improvement of portal hypertension even if an SVR is achieved.
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Fierbinteanu-Braticevici, C., L. Tribus, R. Usvat, A. Moldoveanu, C. Baicus et L. Ionita. « P484 ROLE OF SPLEEN STIFFNESS MEASUREMENT FOR PORTAL HYPERTENSION PREDICTION IN CIRRHOTIC PATIENTS ». Journal of Hepatology 60, no 1 (avril 2014) : S231. http://dx.doi.org/10.1016/s0168-8278(14)60646-2.

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Chin, Jun Liong, Grace Chan, John D. Ryan et P. Aiden McCormick. « Spleen stiffness can non-invasively assess resolution of portal hypertension after liver transplantation ». Liver International 35, no 2 (27 août 2014) : 518–23. http://dx.doi.org/10.1111/liv.12647.

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Shah, Apurva. « Evaluation of Liver and Spleen Stiffness by ARFI in Non-Cirrhotic Portal Hypertension (NCPH) ». Journal of Clinical and Experimental Hepatology 5 (juin 2015) : S56. http://dx.doi.org/10.1016/j.jceh.2015.07.110.

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Hanquinet, Sylviane, Céline Habre, Méryle Laurent, Mehrak Anooshiravani et Seema Toso. « Acoustic radiation force impulse imaging : normal values of spleen stiffness in healthy children ». Pediatric Radiology 51, no 10 (13 mai 2021) : 1873–78. http://dx.doi.org/10.1007/s00247-021-05079-8.

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Abstract Background Acoustic radiation force impulse (ARFI) imaging is a noninvasive ultrasound elastography technique for evaluating tissue stiffness. The association of liver and spleen stiffness provides additional information in the assessment of portal hypertension. The technique and normal values of spleen stiffness by point shear wave elastography (p-SWE) in pediatrics have not been well documented. Objective Our aim is to describe the feasibility and normal ARFI elastography values in the spleen for healthy children and to compare measurements in two different probe positions (the axial and sagittal planes). Materials and methods Spleen p-SWE using ARFI values were measured with a 6C1 probe in 102 healthy children (age range: 8 weeks to 17 years) divided into four age groups. An average of nine (standard deviation: two) spleen stiffness measurements were taken during free breathing in each plane (axial and sagittal). The impact of age and measurement plane in the spleen was analyzed using multivariate models. Results There was no significant difference in spleen stiffness values taken at different ages, with an average of the medians of 2.43±0.31 m/s. There was no significant difference based on probe orientation: sagittal plane (median: 2.46±0.29 m/s) and axial plane (median: 2.43±0.32 m/s) with Student’s t-test P=0.18. The mean depth of measurement varied between 2.3 cm and 3.7 cm, according to age. Conclusion Normal spleen stiffness values using ARFI imaging in children do not vary with age and correspond to a median of 2.43 m/s. No significant difference was found when using different probe positions.
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Grgurevic, Ivica, Tomislav Bokun, Tonci Bozin, Vladimir Matic, Sara Haberle et Ioan Sporea. « Non-invasive diagnosis of portal hypertension in cirrhosis using ultrasound based elastography ». Medical Ultrasonography 19, no 3 (3 mai 2017) : 310. http://dx.doi.org/10.11152/mu-1019.

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Liver stiffness measurement (LSM) by ultrasound-based elastography may be used to non-invasively discriminate between the stages of liver fibrosis, rule out cirrhosis and follow its evolution, including the prediction of the presence of oesophageal varices. The same is possible in order to diagnose clinically significant portal hypertension, referring primarilyto transient elastography and LSM values ≥20-25 kPa. The same approach may be used to reliably rule out the presence ofoesophageal varices (LSM <20 kPa + platelets >150x109/L). These recommendations refer primarily to patients with viral aetiology of chronic liver disease (hepatitis C), while additional studies are required for other aetiologies. While spleen stiffness measurement (SSM) also poses a logical choice in this indication, controversial results have nevertheless been published on this issue. It should be emphasized, however, that more recent data indicate that this parameter should be included in the diagnostic algorithm for portal hypertension, if not as the sole then as a part of a sequential algorithm, combined with LSM. Until now, transient elastography has been most extensively studied and founded on scientific evidence, although the results of other ultrasound-based elastography techniques demonstrate the same trend for the non-invasive assessment of portal hypertension.
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Colecchia, Antonio, Giovanni Marasco, Martina Taddia, Lucia Montrone, Leonardo H. Eusebi, Daniele Mandolesi, Ramona Schiumerini, Anna R. Di Biase et Davide Festi. « Liver and spleen stiffness and other noninvasive methods to assess portal hypertension in cirrhotic patients ». European Journal of Gastroenterology & ; Hepatology 27, no 9 (septembre 2015) : 992–1001. http://dx.doi.org/10.1097/meg.0000000000000393.

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Giuffrè, Mauro, Daniele Macor, Flora Masutti, Fabio Tinè, cristiana abazia, Riccardo Patti, Matteo Rossano Buonocore et al. « SAT-040-Is spleen stiffness the new frontier for non-invasive assessment of portal hypertension ? » Journal of Hepatology 70, no 1 (avril 2019) : e644. http://dx.doi.org/10.1016/s0618-8278(19)31282-4.

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Song, Jinzhen, Jianbo Huang, He Huang, Shiyu Liu et Yan Luo. « Performance of spleen stiffness measurement in prediction of clinical significant portal hypertension : A meta-analysis ». Clinics and Research in Hepatology and Gastroenterology 42, no 3 (juin 2018) : 216–26. http://dx.doi.org/10.1016/j.clinre.2017.11.002.

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Ahmad, Ayesha K., Sebastiana Atzori, Simon D. Taylor-Robinson, James B. Maurice, Graham S. Cooke et Lucy Garvey. « Spleen stiffness measurements using point shear wave elastography detects noncirrhotic portal hypertension in human immunodeficiency virus ». Medicine 98, no 47 (novembre 2019) : e17961. http://dx.doi.org/10.1097/md.0000000000017961.

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Stefanescu, H., B. Procopet, G. Allegretti, A. Berzigotti, N. Gamal, F. Conti, D. Festi et al. « Diagnostic accuracy of liver and spleen stiffness measurement for portal hypertension using bidimensional shear weave elastography ». Digestive and Liver Disease 47 (février 2015) : e18. http://dx.doi.org/10.1016/j.dld.2015.01.042.

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Padalino, Massimo A., Liliana Chemello, Luisa Cavalletto, Annalisa Angelini et Marny Fedrigo. « Prognostic Value of Liver and Spleen Stiffness in Patients with Fontan Associated Liver Disease (FALD) : A Case Series with Histopathologic Comparison ». Journal of Cardiovascular Development and Disease 8, no 3 (16 mars 2021) : 30. http://dx.doi.org/10.3390/jcdd8030030.

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The Fontan operation is the current surgical procedure to treat single-ventricle congenital heart disease, by splitting the systemic and pulmonary circulations and thus permitting lifespan to adulthood for the majority of newborns. However, emerging data are showing that Fontan-associated liver disease (FALD) is an increasing related cause of morbidity and mortality in patients with the Fontan circuit. We described the clinical, laboratory, and transient elastography (TE) findings in a case series of adults with the Fontan circuit, and also correlated data with post-mortem histological features, aimed to define the prognostic value of TE in the staging of FALD. All patients presented signs of a long-standing Fontan failure, characterized by reoperation need, systemic ventricle dysfunction, and FALD stigmata (liver and spleen enlargement, portal vein and inferior vena cava dilation, and abnormal liver function tests). Liver and spleen stiffness (LS and SS) values were indicative of significant liver fibrosis/cirrhosis and the presence of suggestive portal hypertension (LS mean 35.9; range 27.3–44.7 kPa; SS mean 42.1, range 32.2–54.5 kPa). Post-mortem evaluations confirmed a gross hepatic architecture distortion in all cases. All patients died from severe complications related to liver dysfunction and bleeding. TE correlated well with pathological findings and FALD severity. We propose this validated and harmless technique to monitor liver fibrosis extension and portal hypertension over time in Fontan patients, and to identify the optimal timing for surgical reoperations or orthotopic-heart transplantation (OHT), avoiding a higher risk of morbidity and mortality in cases with severe FALD.
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Yuldashev, R. Z., M. M. Aliev, Sh I. Shokhaydarov et D. B. Tursunova. « Spleen stiffness measurement as a non-invasive test to evaluate and monitor portal hypertension in children with extrahepatic portal vein obstruction ». Pediatric Surgery International 36, no 5 (23 mars 2020) : 637–41. http://dx.doi.org/10.1007/s00383-020-04648-6.

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Zhou, Huihui, Zhilin Zhang, Jun Zhang, Lin Sang, Lina Liu, Yong Lv, Xue Gong et al. « Spleen Stiffness Performance in the Noninvasive Assessment of Gastroesophageal Varices after Transjugular Intrahepatic Portosystemic Shunts ». BioMed Research International 2021 (17 avril 2021) : 1–8. http://dx.doi.org/10.1155/2021/5530004.

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Objectives. To investigate the performance of spleen stiffness (SS) by using two-dimensional shear-wave elastography (2D-SWE) for assessing the severity of gastroesophageal varices (GEVs) after transjugular intrahepatic portosystemic shunt (TIPS). Methods. 102 eligible patients were categorized as in the post-TIPS short-term ( n = 69 ) and long-term ( n = 38 ) follow-up groups. The performance of SS by using 2D-SWE for evaluating the severity of GEVs was compared with liver stiffness (LS), spleen stiffness-to-liver stiffness ratio (SS/LS), liver stiffness spleen-diameter-to-platelet-ratio score (LSPS), portal hypertension (PH) risk score, platelet count-to-spleen diameter ratio (PSR), and varices risk score by using receiver operating characteristic (ROC) curve and DeLong test. Results. In the post-TIPS short-term follow-up group, area under the receiver operating characteristic curves (AUCs) of SS were 0.585 for mild ( cutoff value = 30.3 kPa), 0.655 for moderate ( cutoff value = 30.6 kPa), and 0.739 for severe ( cutoff value = 31.9 kPa) GEVs, which were higher than other parameters for severe GEVs. AUCs of SS were lower than other parameters for mild and moderate GEVs, but no difference was found ( p > 0.05 ). In the post-TIPS long-term follow-up group, AUCs of SS were 0.778 for mild ( cutoff value = 28.9 kPa), 0.82 for moderate ( cutoff value = 29.9 kPa), and 0.824 for severe ( cutoff value = 37.7 kPa) GEVs, which were higher than other parameters except for severe GEVs. AUC of SS was lower than other parameters for severe GEVs, but no significant difference was found ( p > 0.05 ). Conclusion. SS is an effective noninvasive tool to predict GEV severity during the post-TIPS follow-up.
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Dajti, Elton, Giovanni Marasco, Federico Ravaioli, Luigi Colecchia, Alberto Ferrarese, Davide Festi et Antonio Colecchia. « Risk of hepatocellular carcinoma after HCV eradication : Determining the role of portal hypertension by measuring spleen stiffness ». JHEP Reports 3, no 3 (juin 2021) : 100289. http://dx.doi.org/10.1016/j.jhepr.2021.100289.

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Dajti, Elton, Federico Ravaioli, Antonio Colecchia, Giovanni Marasco, Amanda Vestito et Davide Festi. « Liver and Spleen Stiffness Measurements for Assessment of Portal Hypertension Severity in Patients with Budd Chiari Syndrome ». Canadian Journal of Gastroenterology and Hepatology 2019 (2 janvier 2019) : 1–6. http://dx.doi.org/10.1155/2019/1673197.

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Aims. Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited. This paper describes LSM and SSM in patients with BCS and their correlation with clinical, biochemical, and ultrasound findings from the same patients. Methods. We investigated a case series of seven patients with BCS diagnosis and available LSM and SSM evaluated by transient elastography (TE). Biochemical, imaging, and endoscopic findings nearest to the TE evaluation were recorded. Clinical outcomes and BCS evolution were described for each patient. When available, repeated TE assessments were also recorded. Results. Patients with acute nonfulminant manifestation of BCS presented near-the-upper-limit values (75 kPa) of LSM and SSM, which often persist until the placement of a transjugular intrahepatic portosystemic shunt (TIPS). On the other hand, TE values were markedly lower in patients with compensated BCS. In some patients with repeated TE measurement years after TIPS placement, LSM had decreased to values of <10 kPa years. SSM changes in these patients were, however, less evident. Conclusions. Extremely elevated values of LSM and SSM are suggestive of BCS. The evaluation of both LSM and SSM by TE could help clinicians in the initial evaluation, risk stratification, and therapy response monitoring of patients with BCS.
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Giuffrè, Mauro, Giorgio Bedogni, Cristiana Abazia, Flora Masutti, Claudio Tiribelli et Lory Saveria Crocè. « Spleen stiffness can be employed to assess the efficacy of spontaneous portosystemic shunts in relieving portal hypertension ». Annals of Hepatology 19, no 6 (novembre 2020) : 691–93. http://dx.doi.org/10.1016/j.aohep.2020.07.004.

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Tseng, Yujen, Feng Li, Jian Wang, Shiyao Chen, Wei Jiang, Xizhong Shen et Shengdi Wu. « Spleen and liver stiffness for noninvasive assessment of portal hypertension in cirrhotic patients with large esophageal varices ». Journal of Clinical Ultrasound 46, no 7 (21 août 2018) : 442–49. http://dx.doi.org/10.1002/jcu.22635.

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Sekhar, Mallika, Matteo Roselli, David w. PATCH, Dhiraj Tripathi, Anicee Danaee, Justin Li, Joy Kwong, Dominic Yu et Davide Roccarina. « Spleen Stiffness in Myeloproliferative Disease Related Splanchnic Vein Thrombosis ». Blood 128, no 22 (2 décembre 2016) : 5468. http://dx.doi.org/10.1182/blood.v128.22.5468.5468.

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Abstract Introduction: Myeloproliferative neoplasms (MPN) account for the majority of non-cirrhotic and non-malignant Splanchnic vein thrombosis (SVT). SVT comprises extrahepatic portal vein obstruction (EHPVO), Budd-Chiari syndrome (BCS), mesenteric vein thrombosis (MVT) and splenic vein thrombosis (SpVT). 30% of EHPVO and 45% BCS are attributable to MPN. Portal hypertension (PH) is a major complication of SVT and hepatic and splenic elastography is increasingly used as a non-invasive tool for the characterization of hepatic fibrosis and PH. We had already established in 17 patients with chronic liver disease (CLD) that SS was the only predictor of clinically significant PH (CSPH) with an AUROC of 0.908, SE=0.45, p<0.0001, 95% CI 0.821-0.996, Cut-off 44.3 kPa, sensitivity 88%, specificity 85%. We wished to explore the role of tissue stiffness in characterizing splenomegaly in MPN patients with SVT. Methods: As part of an observational study of patients with MPN-SVT (Mascot study) from September 2015 we assessed 18 patients with MPN-SVT for spleen stiffness (SS) and spleen size (SSz) using point shear wave elastography (ElastoPQ Phillips Healthcare system). 14 patients had measurements at two time points 3-8 months apart (median 4.5m). Their clinical and radiologic details are presented in Table 1. SVT was diagnosed 1-16 years prior to the investigations (median 5 years). Patients were treated with LMWH and warfarin. Most patients also received Aspirin at the outset and 2/14 patients had thrombolysis in the acute phase. Review of SVT with imaging by CT/MR was undertaken at 6-12 monthly intervals. MPN was diagnosed on the basis of blood and bone marrow morphology and molecular analysis. 1 patient had CALR mutation, the others JAK2V617F mutation. Treatment included venesection, Hydroxycarbamide, Pegylated Interferon and Ruxolitinib. Results: 8/14 were male, median age 45 years. All patients had splenomegaly at baseline. All patients showed stable or improved appearances of the site of thrombus with patent TIPS on follow-up imaging. 9/14 were on MPN directed medication; median time between commencing medication and 1st SS measurement was 3 months (range -3m to 7 yrs) including 1 patient who commenced Ruxolitinib 3 months after 1st assessment but 7 months before the 2nd assessment (patient 12). In 6/14 patients SS worsened (pts 1-6, Table 1), SSz was stable or worse. 4/6 had TIPS and 4/6 had cytoreductive treatment including 2 receiving Ruxolitinib. In 6 patients SS reduced along with a reduction in SSz (pts 9-14). 2 had TIPS and 5/6 had cytoreductive treatment including 4 receiving Ruxolitinib. Patients with increasing SS over time also had microcytic erythrocytosis that persisted over the period of measurement. Patients with improving SS had improvement in the MCV leading to normal values of RBC and MCV (Fig 1). Conclusions: In this small pilot study on a cohort of well characterised MPN-SVT patients we have assessed SS and considered clinical variables affecting this. This study shows that 1. Spleen elastography provides a novel method of characterising the spleen. In patients with CLD it correlates well with clinically significant PH. 2. All patients with MPN-SVT have residual splenomegaly 3. Patients had no recurrence of the SVT after adequate anticoagulation was instituted. 4. More patients with reduction in SS received JAK2 inhibitor drugs. 5. Reduction in SS is not a consistent feature of PH reduction via TIPS. 6. Persistent microcytic erythrocytosis is seen in the patients with worsening spleen stiffness and improvement in patients with improving stiffness. 7. The dynamics of splenomegaly in these patients remains unclear. Discussion: TIPS reduces portal pressure and in PH related to CLD and thereby reduces SSz. In our patients this has not been a consistent result. Previous studies have shown a reduction in SSz with Ruxolitinib. In our patients the reduction is size and stiffness is noted in patients on Ruxolitinib/Pegylated Interferon but it is not consistent. This lack of response in some patients occurs despite normalisation /improvement of counts. The persistence of splenomegaly with abnormal stiffness in the face of TIPS and cytoreduction is puzzling and worthy of longitudinal studies using elastography which may offer valuable insights into the role and behaviour of the spleen in these disorders. Figure Figure. Disclosures Sekhar: Novartis: Research Funding.
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Ravaioli, Federico, Antonio Colecchia, Elton Dajti, Giovanni Marasco, Luigina Vanessa Alemanni, Mariarosa Tamè, Francesco Azzaroli, Stefano Brillanti, Giuseppe Mazzella et Davide Festi. « Spleen stiffness mirrors changes in portal hypertension after successful interferon-free therapy in chronic-hepatitis C virus patients ». World Journal of Hepatology 10, no 10 (27 octobre 2018) : 731–42. http://dx.doi.org/10.4254/wjh.v10.i10.731.

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Ravaioli, F., E. Dajti, A. Colecchia, V. Alemanni, G. Marasco, M. Tamé, F. Azzaroli, S. Brillanti, G. Mazzella et D. Festi. « Spleen stiffness decrease as mirror of portal hypertension changes after successful interferon-free therapy in chronic-HCV patients ». Journal of Hepatology 68 (avril 2018) : S654—S655. http://dx.doi.org/10.1016/s0168-8278(18)31564-2.

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Furuichi, Yoshihiro, Fuminori Moriyasu, Junichi Taira, Katsutoshi Sugimoto, Takatomo Sano, Shigeki Ichimura, Yuki Miyata et Yasuharu Imai. « Noninvasive diagnostic method for idiopathic portal hypertension based on measurements of liver and spleen stiffness by ARFI elastography ». Journal of Gastroenterology 48, no 9 (10 novembre 2012) : 1061–68. http://dx.doi.org/10.1007/s00535-012-0703-z.

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Wehmeyer, Malte H., Harsha Sekhri, Raluca Wroblewski, Antonio Galante, Thomas Meyer, Ansgar W. Lohse et Julian Schulze zur Wiesch. « Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis ». PLOS ONE 17, no 7 (18 juillet 2022) : e0271541. http://dx.doi.org/10.1371/journal.pone.0271541.

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Background Asplenia or functional hyposplenism are risk factors for severe infections, and vaccinations against encapsulated bacteria are advised. There are only limited data regarding the spleen function of cirrhotic patients. Methods We evaluated spleen function in patients with liver cirrhosis, who were prospectively enrolled in this study. Spleen function was evaluated by the measurement of pitted erythrocytes. Functional hyposplenism was defined as a percentage of PE of >15%. Results 117 patients, mean age 58.4 years and 61.5% (n = 72) male with liver cirrhosis were included. Functional hyposplenism was diagnosed in 28/117 patients (23.9%). Pitted erythrocytes correlated with albumin (p = 0.024), bilirubin (p<0.001), international normalized ratio (INR; p = 0.004), model of end-stage liver disease (MELD) score (p<0.001) and liver stiffness (p = 0.011). Patients with functional hyposplenism had higher MELD scores (median 13 vs. 10; p = 0.021), liver stiffness (46.4 kPa vs. 26.3 kPa; p = 0.011), INR (1.3 vs. 1.2; p = 0.008) and a higher Child-Pugh stage (Child C in 32.1% vs. 11.2%; p = 0.019) as compared to patients without functional hyposplenism. Functional hyposplenism was not associated with the etiology of cirrhosis. Importantly, 9/19 patients with Child C cirrhosis had functional hyposplenism. Conclusion A quarter of patients with liver cirrhosis and almost 50% of patients with Child C cirrhosis have functional hyposplenism. Functional hyposplenism is associated with poor liver function and the degree of portal hypertension, which is characterized by higher liver stiffness measurements in transient elastography.
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Sovaila, Silvia, Adrian Purcarea, Jean Pierre Fauchart, Dan Gheonea et Tudorel Ciurea. « Hyaluronic Acid, Spleen Size and Prothrombin Time Predict the Existence of High-Risk Esophageal Varices in Non-Viral Cirrhosis in Real Life ». Internal Medicine 17, no 1 (1 mars 2020) : 7–19. http://dx.doi.org/10.2478/inmed-2020-0097.

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AbstractBackground and aims. Biomarkers are a simple and inexpensive way to replace the invasive diagnostic test(1,2). Portal hypertension screening recommendations in cirrhotic patients propose two such biomarkers: the platelet count and liver elastography. This recommendation derives from studies on viral cirrhosis(3). Viral cirrhosis is biologically and histologically different from steatosis related cirrhosis and traditional biomarkers used for high-risk varices screening might not be of use in this category. We aimed to evaluate their utility compared to other biomarkers for the prediction of high-risk varices of non-viral etiology in cirrhotic patients.Methods. Our current study is a monocentric, real-life, cross-sectional analysis of non-viral cirrhosis patients.Results. 50 patients with suspected cirrhosis, who underwent upper gastrointestinal endoscopy, were included prospectively for over 8 months and 41 were analyzed. The etiology was steatohepatitis (alcohol and non-alcohol related steatohepatitis). Hyaluronic acid (AUC 0.866, r =0.600), prothrombin time (AUC 0.708, r =0.445) and spleen size (AUC 0.763, r =0.337) significantly correlated with high-risk esophageal varices. In the meantime, liver stiffness was difficult to obtain and only correlated modestly with high-risk esophageal varices and platelet count was a poor predictor of high-risk esophageal varices in this mainly steatosis related cohort of cirrhotic patients.Conclusion. We proposed hyaluronic acid, spleen size and prothrombin time as alternatives biomarkers for portal hypertension in steatohepatitis patients. Their potency should be further proven in larger studies.
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Iurlo, Alessandra, Daniele Cattaneo, Mariangela Giunta, Umberto Gianelli, Giovanni Casazza, Mirella Fraquelli, Nicola Orofino et al. « Spleen Stiffness Measurement By Transient Elastography As a Predictor of Bone Marrow Fibrosis in Primary Myelofibrosis Patients ». Blood 124, no 21 (6 décembre 2014) : 1825. http://dx.doi.org/10.1182/blood.v124.21.1825.1825.

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Abstract Introduction: transient elastography (TE) is a standardized, non-invasive tool which predicts severity of chronic liver disease (CLD). Owing to the known relationships between liver fibrosis, portal hypertension and splenomegaly, the measurement of spleen stiffness (SS) has been evaluated as an alternative and/or complementary method to liver stiffness (LS) in order to evaluate liver disease severity. In particular, a significant correlation between SS and portal hypertension has been established with hemodynamic measurements, demonstrating that SS accurately predicts the risk of both esophageal varices and clinical decompensation in patients with viral cirrhosis. Recently, we conducted a study in CLD patients with the aim to assess the diagnostic accuracy of combined LS and SS in the prediction of liver fibrosis and portal hypertension; it also included 64 healthy volunteers and 48 patients with a previous diagnosis of hematological malignancies as control population. Among the few hematological patients enrolled in that study, a significant correlation between SS and bone marrow fibrosis grade (p<0.01) was found and it was more pronounced in the 23 primary myelofibrosis (PMF) patients than in those with other hematological neoplasms. Methods: to validate further these preliminary observations, we enrolled 108 patients with a clinical and histological diagnosis of PMF based on WHO 2008 criteria. All patients concurrently underwent liver and spleen TE, in conjunction with a bone marrow biopsy, ultrasound evaluation of spleen size and chemistries. Once we found normal LS values granted for the absence of liver disease potentially interfering with SS assessments, according to the updated WHO classification, we considered only two main bone marrow fibrosis categories defined as follows: pre-fibrotic/early fibrotic (MF-0/1) and advanced fibrotic stage (MF-2/3). Results: transient elastography of the liver and spleen was successfully performed in 88 PMF patients (81.5%), whereas 20 (18.5%) had indeterminate spleen-TE results; however, this rate of spleen-TE failure is similar to that reported by previous studies in CLD patients (15 to 20% of all cases). The median liver-TE and spleen-TE values were 7.1 kPa (range 3.5-19.6) and 40.1 kPa (range 11.8–75.0), respectively. In a univariate analysis both spleen (p<.0001) and liver stiffness (p=.0074) correlated with the severity of bone marrow fibrosis, whereas age, gender and the PMF prognostic scoring systems IPSS, DIPSS and DIPSS-plus did not. Furthermore, bone marrow fibrosis did not correlate with the presence of JAK2 V617F or CALR mutations, whereas it did with Hb (p=0.0001), LDH (p<.0001) and peripheral blood CD34-positive cells count (p=0.0003). At multivariate analysis, only SS, LDH and CD34-positive cells count maintained a significant correlation with bone marrow fibrosis, with a discriminative ability assessed by the c statistic of 0.904 (95% CI, 0.841-0.967). According to these results, we were able to propose an equation for the estimation of the probability of being MF-2/3, arranged as follows: probability MF-2/3= exp[-4.83+0.0380*SS+0.0039*LDH+0.0148*CD34]/[1+exp(-4.83+0.0380*SS+0.0039*LDH+0.0148*CD34)]. The model entails two decisional threshold values that predict the probability of diagnosing PMF severity: the best cut-off for the diagnosis of MF-0/1 was 0.15 (negative predictive value=0.97) and the best cut-off for the diagnosis of MF-2/3 was 0.73 (positive predictive value=0.94), with an accuracy of 97% for the former and 94% for the latter. Figure 1 describes the two decisional thresholds and the distribution of our patients in the MF-0/1 and MF-2/3 categories. Conclusions: to our knowledge, this study represents the first attempt to evaluate the entity of SS in PMF patients as a measure of disease severity. Furthermore, our results allow us to suggest the use of SS as a surrogate marker of bone marrow fibrosis, particularly following the fibrogenetic progression of the disease, especially when it is considered together with such routine chemistries as LDH and CD34-positive cells count, a finding that may limit the need for an invasive and more expensive procedure like bone marrow biopsy in the management of PMF patients. Figure 1 Patients’ distribution in the two main bone marrow fibrosis categories according to the predicted probability cut-off values Figure 1. Patients’ distribution in the two main bone marrow fibrosis categories according to the predicted probability cut-off values Disclosures No relevant conflicts of interest to declare.
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Armandi, A., C. Labenz, M. M. Werner, M. Michel, F. Thieringer, C. Schoelch, J. Ertle, H. O. Coxson, P. R. Galle et J. M. Schattenberg. « The use of Spleen Stiffness Measurement for the detection of high-risk esophageal varices in patients with portal hypertension ». Digestive and Liver Disease 54 (mars 2022) : S19—S20. http://dx.doi.org/10.1016/j.dld.2022.01.036.

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Calvaruso, V., V. Di Marco, F. Bronte, G. Licata, F. Simone, G. Butera, G. Pecoraro et al. « 10 SPLEEN STIFFNESS CORRELATES WITH PORTAL HYPERTENSION AND INCREASES THE ACCURACY OF DETECTION OF ESOPHAGEAL VARICES IN HCV CIRRHOSIS ». Digestive and Liver Disease 42 (février 2010) : S4—S5. http://dx.doi.org/10.1016/s1590-8658(10)60380-5.

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Attia, D., B. Schoenemeier, T. Rodt, A. Negm, H. Lenzen, T. Lankisch, M. Manns, M. Gebel et A. Potthoff. « Evaluation of Liver and Spleen Stiffness with Acoustic Radiation Force Impulse Quantification Elastography for Diagnosing Clinically Significant Portal Hypertension ». Ultraschall in der Medizin - European Journal of Ultrasound 36, no 06 (13 novembre 2015) : 603–10. http://dx.doi.org/10.1055/s-0041-107971.

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Ortiz, Guillermo A., Chiara Palumbo, Mubarak W. Sayyar, Maya Balakrishnan, Arpan Mohanty et Guadalupe Garcia-Tsao. « Su1696 SPLEEN STIFFNESS MEASUREMENTS (SSM) IN THE IDENTIFICATION OF CLINICALLY-SIGNIFICANT PORTAL HYPERTENSION (CSPH) IN PATIENTS WITH COMPENSATED CIRRHOSIS. » Gastroenterology 158, no 6 (mai 2020) : S—1385. http://dx.doi.org/10.1016/s0016-5085(20)34131-7.

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Calvaruso, V., V. Di Marco, F. Bronte, G. Licata, F. Simone, G. Butera, G. Pecoraro et al. « 388 SPLEEN STIFFNESS CORRELATES WITH PORTAL HYPERTENSION AND INCREASES THE ACCURACY OF DETECTION OF ESOPHAGEAL VARICES IN HCV CIRRHOSIS ». Journal of Hepatology 52 (avril 2010) : S159—S160. http://dx.doi.org/10.1016/s0168-8278(10)60390-x.

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Sun, Xiaohui, Li Zhang, Ling Jiang, Ligang Cui et Xiaoguang Li. « Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients ». Diagnostics 12, no 12 (23 novembre 2022) : 2909. http://dx.doi.org/10.3390/diagnostics12122909.

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Background and Objectives: Portal hypertension (PH), as the main consequence of cirrhosis, leads to the development of gastroesophageal varices (GEVs). Variceal hemorrhage (VH) caused by the rupture of GEVs is a life-threatening emergency. Thus, the prediction of VH risk is considerably important. Our pilot study aimed to identify the risk factors of variceal hemorrhage (VH) in cirrhosis. Materials and Methods: Cirrhotic patients were prospectively included and divided into two groups according to the presence or absence of VH. Conventional ultrasound and shear wave dispersion (SWD) imaging were conducted to detect the portal vein diameter, spleen diameter, ascites, liver stiffness (LS) and shear wave dispersion slope (SWDS). The laboratory tests were recorded, including platelets (PLT), alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB). The risk factors of VH were screened using univariate analyses and identified using multivariate logistic regression. The ROC curves were used to assess diagnostic accuracy. Comparisons between AUCs were performed using the Delong method. Results: Sixty-five patients with 22 VHs were finally included. The SWDS, spleen diameter and ascites were identified as independent risk factors for VH. The SWDS showed good performance for diagnosing VH (AUC = 0.768, 95% CI: 0.647–0.864), and sensitively identified 95.5% (95% CI: 77.2%–99.9%) of patients with VH. Including the three risk factors in multivariate logistic regression, we obtained a formula for diagnosing VH: −20.749 + 0.804 × SWDS + 0.449 × spleen diameter + 1.803 × ascites (no ascites = 0, ascites = 1). Comparison of AUCs revealed that the formula (AUC = 0.900, 95% CI: 0.800–0.961) performed better than LS, SWDS, and spleen diameter in diagnosing VH (p < 0.001; p < 0.05; p < 0.05). Conclusions: SWDS is a sensitive parameter for assessing the risk of VH. Combining the SWDS, spleen diameter and ascites resulted in good diagnostic accuracy.
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Zhu, Yu‐li, Hong Ding, Tian‐tian Fu, Shi‐yun Peng, Shi‐yao Chen, Jian‐jun Luo et Wen‐ping Wang. « Portal hypertension in hepatitis B‐related cirrhosis : Diagnostic accuracy of liver and spleen stiffness by 2‐D shear‐wave elastography ». Hepatology Research 49, no 5 (28 janvier 2019) : 540–49. http://dx.doi.org/10.1111/hepr.13306.

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Colecchia, Antonio, Lucia Montrone, Eleonora Scaioli, Maria Letizia Bacchi–Reggiani, Agostino Colli, Giovanni Casazza, Ramona Schiumerini et al. « Measurement of Spleen Stiffness to Evaluate Portal Hypertension and the Presence of Esophageal Varices in Patients With HCV-Related Cirrhosis ». Gastroenterology 143, no 3 (septembre 2012) : 646–54. http://dx.doi.org/10.1053/j.gastro.2012.05.035.

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Mihăilă, Romeo-Gabriel. « Liver stiffness in chronic hepatitis C virus infection ». Romanian Journal of Internal Medicine 57, no 2 (1 juin 2019) : 85–98. http://dx.doi.org/10.2478/rjim-2018-0034.

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Abstract Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.
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Elkrief, Laure, Pierre-Emmanuel Rautou, Maxime Ronot, Simon Lambert, Marco Dioguardi Burgio, Claire Francoz, Aurélie Plessier et al. « Prospective Comparison of Spleen and Liver Stiffness by Using Shear-Wave and Transient Elastography for Detection of Portal Hypertension in Cirrhosis ». Radiology 275, no 2 (mai 2015) : 589–98. http://dx.doi.org/10.1148/radiol.14141210.

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Vonghia, L., W. Verlinden, T. Vanwolleghem, P. Michielsen et S. Francque. « P0183 : Measurement of spleen and liver stiffness by shear wave elastography to noninvasively evaluate hepatic venous pressure gradient and portal hypertension ». Journal of Hepatology 62 (avril 2015) : S372. http://dx.doi.org/10.1016/s0168-8278(15)30402-5.

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Colecchia, A., L. Montrone, E. Scaioli, M. L. Bacchi-Reggiani, R. Schiumerini, L. Turco, A. R. Di Biase, G. Mazzella et D. Festi. « OC.10.7 : SPLEEN STIFFNESS MEASUREMENT : A NEW NON INVASIVE PREDICTOR OF PORTAL HYPERTENSION AND ESOPHAGEAL VARICES IN VIRAL CHRONIC LIVER DISEASE ». Digestive and Liver Disease 43 (mars 2011) : S142. http://dx.doi.org/10.1016/s1590-8658(11)60213-2.

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Di Marco, V., F. Bronte, V. Calvaruso, C. Cammà, D. Cabibi, G. Licata, F. Simone et A. Craxì. « Fibrospleen : Measuring spleen stiffness by transient elastography increases accuracy of staging of liver fibrosis and of portal hypertension in chronic viral hepatitis ». Digestive and Liver Disease 41, no 3 (mars 2009) : A38. http://dx.doi.org/10.1016/j.dld.2008.12.078.

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Di Marco, V., F. Bronte, V. Calvaruso, C. Cammà, D. Cabibi, G. Licata, F. Simone et A. Craxì. « 391 FIBROSPLEEN : MEASURING SPLEEN STIFFNESS BY TRANSIENT ELASTOGRAPHY INCREASES ACCURACY OF STAGING OF LIVER FIBROSIS AND OF PORTAL HYPERTENSION IN CHRONIC VIRAL HEPATITIS ». Journal of Hepatology 50 (avril 2009) : S148. http://dx.doi.org/10.1016/s0168-8278(09)60393-7.

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