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Auteur : Grafiati
Publié le 10 mars 2023

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1

Ran, Hai-Tao, Xiao-Ping Ye, Yuan-Yi Zheng, Da-Zhi Zhang, Zhi-Gang Wang, Johnson Chen, David Madoff et Jing Gao. « Spleen Stiffness and Splenoportal Venous Flow ». Journal of Ultrasound in Medicine 32, no 2 (février 2013) : 221–28. http://dx.doi.org/10.7863/jum.2013.32.2.221.

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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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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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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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Abraldes, Juan G., Enric Reverter et Annalisa Berzigotti. « Spleen stiffness : Toward a noninvasive portal sphygmomanometer ? » Hepatology 57, no 3 (12 février 2013) : 1278–80. http://dx.doi.org/10.1002/hep.26239.

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Auteri, Giuseppe, Vito Sansone, Daniela Bartoletti, Christian Di Pietro, Emanuele Sutto, Camilla Mazzoni, Nicola Vianelli, Michele Cavo, Fabio Piscaglia et Francesca Palandri. « Spleen and Liver Fibrosis Is Associated to Treatment Response and Prognosis in Philadelphia-Negative Chronic Myeloproliferative Neoplasms ». Blood 138, Supplement 1 (5 novembre 2021) : 3626. http://dx.doi.org/10.1182/blood-2021-152866.

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Abstract Introduction: Spleen and liver stiffness, investigated by transient elastography (TE), have been associated with marrow fibrosis in patients (pts) with Ph-negative myeloproliferative neoplasms (MPNs) (Iurlo et al, Br J Haematol. 2015; Webb et al, Ultrasound Q. 2015). Morover, spleen stiffness was found to be greater in Myelofibrosis (MF) and Polycythemia Vera (PV) compared to Essential Thrombocythemia (ET) (Benedetti et al, J Clin Med. 2020). Tissue stiffness can be assessed by ultrasound shear wave elastography (SWE), the two most common techniques being point SWE (pSWE) and bidimensional SWE (2D.SWE). Aims: The aims of this study are: 1) to identify TE differences between MPN pts and healthy volunteers (HV); 2) to evaluate specific TE features in pts with MF, PV and ET; 3) to assess whether spleen/liver stiffness may identify clinical-laboratory features associated with prognosis in MPNs Methods: In this monocentric study, MPN pts and HV received elastometric evaluation of spleen and liver stiffness by pSWE and 2D.SWE with an Esaote MyLab™9 ultrasound system. Spleen area, portal (PVD) and splenic vein diameter (SVD) were measured. Results: A total of 220 pts were included in this study: 142 (64.5%) MPN and 78 (35.5%) HV. MPN pts were affected by MF (63, 44.4%: 39 primary MF), PV (33, 23.2%) or ET (46, 32.4%). Compared to HV, MPN pts had greater median spleen maximal cross sectional area (79 vs 38 cm2, p<0.001), greater spleen stiffness (pSWE 31.3 vs 23.7 kPa, p<0.001; 2D.SWE 25.2 vs 18.7 kPa, p<0.001), and greater liver stiffness (pSWE 6.0 vs 4.9 kPa, p<0.001; 2D.SWE 5.4 vs 4.7 kPa, p<0.001). Additionally, PVD and SVD were significantly larger in MPNs than in HV (PVD 10.9 vs 9.2 mm, p<0.001; SVD 8 vs 6.3 mm, p<0.001). Comparing each MPN to HV, only MF retained all the significant differences; conversely, liver stiffness and PVD were comparable between ET/PV and HV. Clinical and laboratory features of MPN pts are shown in Tab 1. Compared to PV and ET pts, MF pts had higher spleen (p<0.001) and liver stiffness (p<0.001), larger PVD (p<0.001) and SVD (p<0.001). Conversely, ET and PV displayed comparable TE values. Notably, higher median spleen area (p<0.001), larger SVD (p=0.03) and PVD (p=0.02), higher liver (pSWE/2D.SWE, p<0.001/p=0.002) and spleen stiffness (pSWE/2D.SWE, p=0.01/p=0.001) were associated with increased marrow fibrosis grade. Grade 0-1 marrow fibrosis was present in 15 MF, 17 PV and 34 ET pts. Considering only these 66 MPN pts, spleen (40.8 vs 31.3/25.6 in PV/ET, p=0.006) and liver (6.5 vs 5.6/4.7 in PV/ET, p=0.01) stiffness was significantly higher in MF pts. Notably, increased spleen fibrosis was significantly associated with thrombotic history (32.2 vs 24.3 kPa in pts without previous thrombosis, p=0.02). Also, MPN pts with splanchnic vein thrombosis had higher spleen (pSWE: p<0.001; 2D.SWE: p<0.001) and liver stiffness (pSWE: p <0.001), and increased PVD (p=0.02) and spleen area (p=0003). In MF pts, TE data did not correlate with DIPSS risk category. However, a higher spleen stiffness (pSWE/2D.SWE, p=0.09/ p=0.03), liver stiffness (pSWE/2D.SWE, p=0.001/p=0.01), PVD (p=0.002), and SVD (p=0.01) were associated with larger spleen length by palpation. Also, a reduced SVD was associated with the presence of ≥1 high molecular risk mutation (HMR) (p=0.04). As expected, MF pts treated with JAK-inhibitors showed larger spleen area (143.8 vs 83.7 cm 2, p=0.01) and higher spleen stiffness (34.3 vs 24 kPa, p=0.01) compared to pts under cytoreductive therapy. However, pts in spleen response at the time of TE had lower median SVD/PVD (p=0.05/p=0.07) and reduced spleen stiffness (sSWE/2D.SWE: 31.5/25.9 vs 39.0/32.8 in non-responders, p=0.01/p=0.04) In ET/PV, TE data were comparable in pts with/without a complete hematological response. However, IFN was associated with enlarged spleen area and stiffness compared to cytoreduction. Conclusions: TE evaluation effectively distinguishes MF pts from HV and ET/PV, while ET/PV show relevant similarities to each other and to HV. TE data were significantly associated with prognostically relevant features including marrow fibrosis and history of thrombosis in all MPNs, and presence of large splenomegaly and HMR in MF. Finally, TE data were significantly associated with spleen response in MF. Overall, spleen/liver stiffness may help in correct MPN diagnosis, and may provide clinical guidance, being associated with known prognostic factors and treatment outcome. Figure 1 Figure 1. Disclosures Cavo: Bristol-Myers Squib: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Adaptive Biotechnologies: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; GlaxoSmithKline: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Speakers Bureau; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Accommodations, Speakers Bureau. Piscaglia: ESAOTE: Research Funding. Palandri: CTI: Consultancy; AOP: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Sierra Oncology: Membership on an entity's Board of Directors or advisory committees.
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Cho, Young Seo, Sanghyeok Lim, Yongsoo Kim, Joo Hyun Sohn et Jae Yoon Jeong. « Spleen Stiffness Measurement Using 2-Dimensional Shear Wave Elastography : The Predictors of Measurability and the Normal Spleen Stiffness Value ». Journal of Ultrasound in Medicine 38, no 2 (23 juillet 2018) : 423–31. http://dx.doi.org/10.1002/jum.14708.

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Fofiu, Renata, Felix Bende, Raluca Lupuşoru, Roxana Şirli, Alina Popescu et Ioan Sporea. « Spleen Stiffness for Predicting Varices Needing Treatment : Comparison between Two Different Elastography Techniques (Point vs. 2D-SWE) ». Canadian Journal of Gastroenterology and Hepatology 2021 (26 mars 2021) : 1–9. http://dx.doi.org/10.1155/2021/6622726.

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The study aimed to establish the benefits of using spleen stiffness values measured by two elastography techniques as noninvasive markers for predicting varices needing treatment and comparing their performances. A prospective study was performed, including 107 subjects with compensated liver cirrhosis, who underwent upper digestive endoscopy, as well as spleen stiffness measurements by means of two elastography techniques: pSWE (point shear wave elastography using Virtual Touch Quantification-Siemens Acuson S2000) and 2D-SWE (2D-shear wave elastography-LOGIQ E9, General Electric). Reliable spleen stiffness measurements were obtained in 96.2% (103/107) patients by means of 2D-SWE and in 94.4% (101/107) subjects with pSWE; therefore, 98 subjects were included in the final analysis, of which 40.8% (40/98) had varices needing treatment. The optimal spleen stiffness cut-off value by 2D-SWE for predicting varices needing treatment was 13.2 kPa (AUROC 0.84), while for pSWE, it was 2.91 m/s (AUROC 0.90). Based on AUROC comparison, no difference between the performance of the two techniques for predicting varices needing treatment was found ( p = 0.1606 ). In conclusion, spleen stiffness measured by either 2D-SWE or pSWE is a reliable surrogate marker, with good feasibility, applicability, and predictive accuracy for varices needing treatment, with no significant difference between techniques.
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Sagar Tiwari, Pratap, et Sudhamshu KC. « Spleen Stiffness Measurement as Non-Invasive Surrogate for Esophageal Varices in Chronic Liver Disease ». Journal of Nobel Medical College 11, no 1 (29 juin 2022) : 27–33. http://dx.doi.org/10.3126/jonmc.v11i1.45733.

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Background: In patients with chronic liver diseases, liver and spleen stiffness measurement by elastography is the most recent available noninvasive tool. However, the accuracy for prediction of esophageal varices has been inconsistent across various studies. So, this study was done to evaluate the diagnostic performance of spleen stiffness measurement for detecting esophageal varices. Materials and Methods: This descriptive cross-sectional study was done from 19 March to 30 June 2019. Participants who met inclusion and exclusion criteria were consecutively enrolled for the study and underwent upper gastrointestinal endoscopic examination along with measurement of liver and spleen stiffness by fibroscan. Results: A total of 78 patients were enrolled. Mean age (±SD) was 49.79 (±10.92) years. Of 78 patients, 58 (74.4 %) had esophageal varices. Among patients with varices, Small esophageal varices were present in 44.8 % (26) and large esophageal varices were present in 55.2 % (32).Liver stiffness higher than 21.7 kPa was found to detect patients with large esophageal varices and the area under the receiver operating curve being 0.79 (95% confidence interval: 0.69 – 0.89); p<0.001. It had sensitivity of 100.0% and specificity of 63% in predicting the presence of large esophageal varices. While, spleen stiffness having a cutoff value of 40 kPa with the area under the receiver operating curve being 0.98 (95% confidence interval: 0.96 – 1.00); p<0.001, had sensitivity of 100.0 % and specificity of 87.0 % in predicting the presence of large esophageal varices. Conclusion: Spleen stiffness measurements by Transient Elastography predict large esophageal varices better than liver stiffness measurements.
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Pawluś, Aleksander, Marcin S. Inglot, Kinga Szymańska, Krzysztof Kaczorowski, Bartosz D. Markiewicz, Agnieszka Kaczorowska, Jacek Gąsiorowski et al. « Shear wave elastography of the spleen : evaluation of spleen stiffness in healthy volunteers ». Abdominal Radiology 41, no 11 (7 juillet 2016) : 2169–74. http://dx.doi.org/10.1007/s00261-016-0834-4.

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Buechter, Matthias, et Alisan Kahraman. « Predictive value of spleen stiffness in hepatocellular carcinoma ». Hepatobiliary Surgery and Nutrition 9, no 1 (février 2020) : 101–2. http://dx.doi.org/10.21037/hbsn.2019.09.05.

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Park, Jaehyung, Heejin Kwon, Jinhan Cho, Jongyoung Oh, Sangyun Lee, Sangyeong Han, Sung Wook Lee et Yanghyun Baek. « Is the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology predictive of the presence of esophageal varices in patients with cirrhosis of various etiologies ? » Medical Ultrasonography 18, no 1 (18 septembre 2016) : 11. http://dx.doi.org/10.11152/mu.2013.2066.181.sf.

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Aim: This study’s aimwas to determine the accuracy of the spleen stiffness value acquired using acoustic radiation force impulse (ARFI) technology, to predict the presence of esophageal varices (EVs) in patients with liver cirrhosis of various etiologies.Material and methods: Of the 366 enrolled patients, 192 had hepatitis B virus, 74 had hepatitis C virus, and 100 had alcohol-related cirrhosis. All patients underwent biochemical tests, gastrointestinal endoscopy, and liver and spleen elastography by ARFI. We evaluated the correlation between the presence of EVs and factors including liver and spleen stiffness measured by ARFI, biochemical tests, and other noninvasive measurements, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count (PLT), spleen diameter (SD), PLT to SD ratio, AST to ALT ratio (AAR) score, the AST to PLT ratio index (APRI) score. Result: A univariate analysis revealed that the AAR score, APRI score, PLT, PLT/SD ratio, and spleen elastography variables were all independently associated with EVs (p<0.05). On multivariate analysis, only spleen elastography was associated with EVs (p=0.001). However, in cases of alcohol-induced liver cirrhosis, spleen stiffness was not reliable for the prediction of EVs.Conclusion: Spleen elastography measured using ARFI may serve as a non-invasive method for determining the presence of EVs. However, it is not an appropriate predictor for EVs in alcoholic cirrhosis.
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Sindhu, Nadella, Prakashini Koteshwar et Shiran Shetty. « Point Shear Wave Elastography of the Spleen in Predicting the Presence of Esophageal Varices in Cirrhosis : Liver Stiffness vs. Spleen Stiffness ». Journal of Diagnostic Medical Sonography 36, no 2 (24 octobre 2019) : 95–101. http://dx.doi.org/10.1177/8756479319882006.

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Objective: To determine the diagnostic ability of the spleen and liver stiffness in predicting the presence of esophageal varices (EVs). Methods: A sample of cirrhotic patients, diagnosed with sonography, was recruited. The cohorts’ liver stiffness (LS) and spleen stiffness (SS) were measured with the Philips’ Elast PQ technique. Platelet count and spleen size were also documented. The endoscopic report was used as the diagnostic gold standard. Singular and combined parameters were assessed to determine the presence of EV using an independent variable t test, area under the receiver operating characteristic curve, and multilogistic regression analysis statistical tests. Results: In predicting the presence of EV, there was a statistically significant difference in means of SS (2.13 ± 0.69 m/s vs. 3.23 ± 1.32 m/s) and LS (2.33 ± 1.20 m/s vs. 3.05 ± 1.4 m/s), as well as discriminating between groups of patients, with and without EV. The ability to diagnostically classify EV with SS and LS was fair while the remaining parameters were deemed poor, using a SS cutoff value of 1.99 m/s. Conclusion: Despite the difference in means, none of the assessed parameters demonstrated a better classification ability than endoscopy. LS and SS were equal in the prediction of EV in these patients. The LS estimate of fibrosis would have grossly predicted the presence of varices. However, the addition of SS, for the estimation of varices, provided no significant benefit.
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ÖZDEMİR, Sevim, Tuba Selçuk CAN, Behice Kaniye YILMAZ et Rüştü TURKAY. « Evaluation of Spleen Stiffness Using Point Shear Wave Elastography in Healthy Individuals ». İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no 18 (31 décembre 2022) : 1006–18. http://dx.doi.org/10.38079/igusabder.1033907.

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Aim: Sonoelastography is a non-invasive imaging method used to evaluate the mechanical properties of any tissue. The clinical value of method, the usage of which is increasingly prevailing, is gradually increasing and on account of having newly entered the application field, it is becoming a potential in the research area. Shear wave (SW) propagates faster in stiffer and lower elastic tissues. Studies on liver fibrosis musculoskeletal, breast, prostate, testis, and thyroid nodules accept this principle. In this study, aimed to determine the average values using the point shear wave elastography (pSWE) technique in normal healthy individuals and to determine the relationship of these values with age, gender, body mass index (BMI), and the spleen dimensions.Method: In 2019, patients who had visited the internal medicine service and those who have been directed to this clinics for grayscale ultrasound (US) for various reasons are voluntarily included in the study. The research was carried out consecutively on the same day by two specialist doctors who had 10 and 15 years of experience in ultrasonography and 3-year experience in elastography.Results: 39 (39%) of the 100 patients who participated in the study were men, and 61 (61%) were women. And the ages varied between 32-75 years (y) (54,5±9,5). The average spleen stiffness was found to be 89,2±43,3 kilopascal (kPa) (14,2-152,3) by the first observer and 89,4±41,1 kPa (14,4-151,1) by the second observer.Conclusion: To facilitate the common clinical usage and to evaluate the change in the stiffness of the spleen in different patients, first of all, it is required to determine the normal values of the stiffness of the spleen in healthy individuals using sonoelastography. In this study, the average spleen parenchyma stiffness was detected as higher than in previous studies. The values obtained in this study can be used to function as a comparison to determine the spleen stiffness. They can be used as referential to examine the different spleen pathologies in the clinical environments that use Esaote myLab device and pSWE method.
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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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Bastard, Cécile, Véronique Miette, Paul Calès, Horia Stefanescu, Davide Festi et Laurent Sandrin. « A Novel FibroScan Examination Dedicated to Spleen Stiffness Measurement ». Ultrasound in Medicine & ; Biology 44, no 8 (août 2018) : 1616–26. http://dx.doi.org/10.1016/j.ultrasmedbio.2018.03.028.

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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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Chien, Cheng-Hung, Yi-Lan Lin, Rong-Nan Chien, Ching-Chih Hu, Cho-Li Yen, Tsung-Shih Lee, Po-Jen Hsieh et Chih-Lang Lin. « Transient Elastography for Spleen Stiffness Measurement in Patients With Cirrhosis ». Journal of Ultrasound in Medicine 35, no 9 (1 juillet 2016) : 1849–57. http://dx.doi.org/10.7863/ultra.15.09064.

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Mannelli, Lorenzo, Edmund Godfrey, Ilse Joubert, Andrew J. Patterson, Martin J. Graves, Ferdia A. Gallagher et David J. Lomas. « MR Elastography : Spleen Stiffness Measurements in Healthy Volunteers—Preliminary Experience ». American Journal of Roentgenology 195, no 2 (août 2010) : 387–92. http://dx.doi.org/10.2214/ajr.09.3390.

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Sharma, Praveen, Vijender Kirnake, Pankaj Tyagi, Naresh Bansal, Vikas Singla, Ashish Kumar et Anil Arora. « Spleen Stiffness in Patients With Cirrhosis in Predicting Esophageal Varices ». American Journal of Gastroenterology 108, no 7 (juillet 2013) : 1101–7. http://dx.doi.org/10.1038/ajg.2013.119.

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Manatsathit, Wuttiporn, Hrishikesh Samant, Saurabh Kapur, Thammasin Ingviya, Mohammad Esmadi, Karn Wijarnpreecha et Timothy McCashland. « Accuracy of liver stiffness, spleen stiffness, and LS-spleen diameter to platelet ratio score in detection of esophageal varices : Systemic review and meta-analysis ». Journal of Gastroenterology and Hepatology 33, no 10 (30 mai 2018) : 1696–706. http://dx.doi.org/10.1111/jgh.14271.

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Fofiu, Renata, Sporea Ioan, Bende Felix, Roxana Sirli et Alina Popescu. « Spleen stiffness and liver stiffness for predicting high risk varices in patients with compensated liver cirrhosis ». Journal of Hepatology 73 (août 2020) : S757. http://dx.doi.org/10.1016/s0168-8278(20)31962-0.

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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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Sharma, Praveen, Smruti Ranjan Mishra, Manoj Kumar, Barjesh Chander Sharma et Shiv Kumar Sarin. « Liver and Spleen Stiffness in Patients with Extrahepatic Portal Vein Obstruction ». Radiology 263, no 3 (juin 2012) : 893–99. http://dx.doi.org/10.1148/radiol.12111046.

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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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Hajiani, Eskandar, Abazar Parsi, Saeid Seyedian, Mahmood Latifi, Naghmeh Habibi Kootenaei et Mohammad Javad Rezaei. « Prediction of esophageal varices by spleen stiffness in patients with cirrhosis ». Obesity Medicine 19 (septembre 2020) : 100261. http://dx.doi.org/10.1016/j.obmed.2020.100261.

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Yasar, Temel Kaya, Mathilde Wagner, Octavia Bane, Cecilia Besa, James S. Babb, Stephan Kannengiesser, Maggie Fung, Richard L. Ehman et Bachir Taouli. « Interplatform reproducibility of liver and spleen stiffness measured with MR elastography ». Journal of Magnetic Resonance Imaging 43, no 5 (15 octobre 2015) : 1064–72. http://dx.doi.org/10.1002/jmri.25077.

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Elshaarawy, Omar, Johannes Mueller, Indra Neil Guha, Jane Chalmers, Rebecca Harris, Aleksander Krag, Bjørn Stæhr Madsen et al. « Spleen stiffness to liver stiffness ratio significantly differs between ALD and HCV and predicts disease-specific complications ». JHEP Reports 1, no 2 (août 2019) : 99–106. http://dx.doi.org/10.1016/j.jhepr.2019.05.003.

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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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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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Venkatesh, Sudhakar K., Safa Hoodeshenas, Sandeep H. Venkatesh, Angela Dispenzieri, Morie A. Gertz, Michael S. Torbenson et Richard L. Ehman. « Magnetic Resonance Elastography of Liver in Light Chain Amyloidosis ». Journal of Clinical Medicine 8, no 5 (23 mai 2019) : 739. http://dx.doi.org/10.3390/jcm8050739.

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In this paper, we present our preliminary findings regarding magnetic resonance elastography (MRE) on the livers of 10 patients with systemic amyloidosis. Mean liver stiffness measurements (LSM) and spleen stiffness measurements (SSM) were obtained. Magnetic resonance imaging (MRI) images were analyzed for the distribution pattern of amyloid deposition. Pearson correlation analysis was performed in order to study the correlation between LSM, SSM, liver span, liver volume, spleen span, spleen volume, serum alkaline phosphatase (ALP), N-terminal pro b-type natriuretic peptide (NT pro BNP), and the kappa and lambda free light chains. An increase in mean LSM was seen in all patients. Pearson correlation analysis showed a statistically significant correlation between LSM and liver volume (r = 0.78, p = 0.007) and kappa chain level (r = 0.65, p = 0.04). Interestingly, LSM did not correlate significantly with SSM (r = 0.45, p = 0.18), liver span (r = 0.57, p = 0.08), or serum ALP (r = 0.60, p = 0.07). However, LSM correlated significantly with serum ALP when corrected for liver volume (partial correlation, r = 0.71, p = 0.03) and NT pro BNP levels (partial correlation, r = 0.68, p = 0.04). MRI review revealed that amyloid deposition in the liver can be diffuse, lobar, or focal. MRE is useful for the evaluation of hepatic amyloidosis and shows increased stiffness in hepatic amyloidosis. MRE has the potential to be a non-invasive quantitative imaging marker for hepatic amyloidosis.
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Ma, Xiaowen, Le Wang, Hao Wu, Yuemin Feng, Xibiao Han, Haoran Bu et Qiang Zhu. « Spleen Stiffness Is Superior to Liver Stiffness for Predicting Esophageal Varices in Chronic Liver Disease : A Meta-Analysis ». PLOS ONE 11, no 11 (9 novembre 2016) : e0165786. http://dx.doi.org/10.1371/journal.pone.0165786.

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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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Ahuja, Amisha, Chaitra Banala, Victoria Nguyen, Amit K. Agarwal, Daniel F. Garrido, Oana Mihai, Scott Keith et Dina Halegoua-DeMarzio. « S3252 Spleen Stiffness Measured by Elastography Does Not Correlate With MELD-Na ». American Journal of Gastroenterology 115, no 1 (octobre 2020) : S1701. http://dx.doi.org/10.14309/01.ajg.0000715056.90551.09.

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Zhu, Hao, Huiwen Guo, Xiaochun Yin, Jian Yang, Qin Yin, Jiangqiang Xiao, Yi Wang et al. « Spleen Stiffness Predicts Survival after Transjugular Intrahepatic Portosystemic Shunt in Cirrhotic Patients ». BioMed Research International 2020 (13 novembre 2020) : 1–8. http://dx.doi.org/10.1155/2020/3860390.

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Objectives. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for portal hypertensive complications. Little is known about the ability of spleen stiffness (SS) for predicting the survival of cirrhotic patients undergoing TIPS. This study is to evaluate the influence of SS detected by point shear wave elastography (pSWE) in predicting survival after TIPS. Methods. This retrospective cohort study screened consecutive patients who underwent TIPS and reliable pSWE measurement between October 2014 and September 2017 from our prospectively maintained database. SS values were measured before TIPS. The primary endpoint was the overall survival after TIPS. The Cox regression analysis model was used for univariate and multivariate analyses. A receiver operating characteristic (ROC) curve analysis was performed to calculate the sensitivity, specificity, and positive and negative predictive values. Results. A total of 89 patients were involved in the final analysis. 24 patients (27.0%) died during a median follow-up time of 31 m. Multivariable Cox regression analysis confirmed that higher SS value ( P < 0.001 ), LS value ( P = 0.008 ), diameter of shunt ( P = 0.001 ), and older age ( P < 0.001 ) were independent prognostic factors of survival after TIPS. The risk of death rose 57.440-fold for each SS unit (m/s) increase. SS was also correlated with liver failure after TIPS. ROC analysis showed that the best SS cutoff value was 3.60 m/s for predicting survival, with a sensitivity of 54.2% and specificity of 90.8%. Conclusions. The SS value determined by pSWE in cirrhotic patients was an independent predictive factor for survival after TIPS.
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Rudler, Marika, Thierry Poynard et Dominique Thabut. « Liver Stiffness, Platelets, and Spleen Size Is Reliable in Nondecompensated Cirrhotic Patients ». Gastroenterology 144, no 5 (mai 2013) : 1150. http://dx.doi.org/10.1053/j.gastro.2013.01.065.

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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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Giuffrè, Mauro, Daniele Macor, Flora Masutti, Cristiana Abazia, Fabio Tinè, Riccardo Patti, Matteo Rossano Buonocore et al. « Evaluation of spleen stiffness in healthy volunteers using point shear wave elastography ». Annals of Hepatology 18, no 5 (septembre 2019) : 736–41. http://dx.doi.org/10.1016/j.aohep.2019.03.004.

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Huo, Teh-Ia, Po-Hong Liu et Chia-Yang Hsu. « Predicting post-resection recurrence of hepatocellular carcinoma : Spleen stiffness vs. ALBI grade ». Journal of Hepatology 70, no 4 (avril 2019) : 808. http://dx.doi.org/10.1016/j.jhep.2018.11.020.

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Saito, Yuki, Naoki Matsumoto, Yoshihiro Aizawa, Daisuke Fukamachi, Daisuke Kitano, Toyama Kazuto, Takehiro Tamaki, Hidesato Fujito, Akira Sezai et Yasuo Okumura. « Clinical significance of spleen stiffness in patients with acute decompensated heart failure ». ESC Heart Failure 7, no 6 (13 septembre 2020) : 4005–14. http://dx.doi.org/10.1002/ehf2.13001.

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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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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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Sattanathan, Swetha, Krishnadas Devadas, Shanid Ahmed, Atul Hareendran, Arun Prabhakaran et Nidhin Raveendran. « Spleen Stiffness Measured by 2D-Shear Wave Elastography and Rebleeding Risk in Cirrhotic Patients Undergoing Endoscopic Variceal Ligation for Variceal Bleeding ». GastroHep 2023 (10 janvier 2023) : 1–9. http://dx.doi.org/10.1155/2023/4912991.

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Background and Aims. Endoscopic variceal ligation (EVL) of esophageal varices alters the portal pressure. We observed the changes in 2D-shear wave elastography (2D-SWE) measurements of spleen and liver following EVL and tried to identify the predictors for rebleeding and mortality at 6 months. Methods. A prospective observational study of 202 patients who underwent EVL for bleeding esophageal varices was done. 2D-SWE measurements of liver stiffness (LS) and spleen stiffness (SS) and spleen volume (SV) were measured half an hour before, 1 hour, 2 weeks, and 6 weeks after EVL. All were followed up for 6 months for rebleeding and all-cause mortality. Results. 83 patients were in child C (41%). Difference in SV, SS, and LS at 2 and 6 weeks from baseline was noted as Delta 2 (2nd week post-EVL - pre-EVL SV, LS, and SS) and Delta 3 (6th week post EVL - pre - EVL SV, LS and SS), respectively. Mean Delta 2 VOL and Delta 3 VOL were lower in the bleeding and mortality groups. Delta 2 SS, Delta 3 SS, Delta 2 LS, and Delta 3 LS were higher in the rebleeding and mortality groups. These changes were statistically significant. AUROC in predicting rebleeding was the highest for Delta 2 VOL (0.773) and Delta 3 LS (0.764) amongst the USG parameters that performed better than MELD score (0.677). AUROC in predicting mortality was the highest for Delta 3 VOL and Delta 2 VOL-0.873 and 0.842, respectively, and higher than MELD’s (0.641). Statistically significant variables in binary logistic regression analysis for rebleeding were Delta 3 LS and Delta 3 SS and none for mortality. Conclusion. LS, SS, and SV change after EVL. Changes in liver and spleen stiffness at 6 weeks from baseline had good diagnostic accuracy for predicting rebleeding at 6 months.
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Albayrak, Eda, et Sadık Server. « The relationship of spleen stiffness value measured by shear wave elastography with age, gender, and spleen size in healthy volunteers ». Journal of Medical Ultrasonics 46, no 2 (28 janvier 2019) : 195–99. http://dx.doi.org/10.1007/s10396-019-00929-3.

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Nagai, Koki, Yuji Ogawa, Takashi Kobayashi, Michihiro Iwaki, Asako Nogami, Yasushi Honda, Takaomi Kessoku et al. « Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography ». JGH Open 6, no 1 (14 décembre 2021) : 11–19. http://dx.doi.org/10.1002/jgh3.12689.

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KANİ, Haluk Tarık, Çağlayan KEKLİKKIRAN, İlkay ERGENÇ et Yusuf YILMAZ. « Evaluation of spleen stiffness in healthy population : a vibration-controlled transient elastography study ». Journal of Health Sciences and Medicine 5, no 2 (15 mars 2022) : 689–92. http://dx.doi.org/10.32322/jhsm.1074776.

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Sintusek, Palittiya, Nipaporn Siriporn, Dollapas Punpanich, Voranush Chongsrisawat et Yong Poovorawan. « Spleen and Liver Stiffness to Detect Esophageal Varices in Children with Biliary Atresia ». Journal of Pediatric Gastroenterology & ; Nutrition 69, no 4 (octobre 2019) : 411–15. http://dx.doi.org/10.1097/mpg.0000000000002430.

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Veiga, Zulane S. T., Cristiane A. Villela-Nogueira, Flávia F. Fernandes, Marta G. Cavalcanti, Fátima A. Figueiredo, João L. Pereira, Gustavo H. Pereira et al. « Transient elastography evaluation of hepatic and spleen stiffness in patients with hepatosplenic schistosomiasis ». European Journal of Gastroenterology & ; Hepatology 29, no 6 (juin 2017) : 730–35. http://dx.doi.org/10.1097/meg.0000000000000853.

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Chin, Jun Liong, Grace Chan, John D. Ryan et Aiden P. McCormick. « Why is Spleen Stiffness Better at Predicting Large Esophageal Varices and Variceal Bleeders ? » American Journal of Gastroenterology 109, no 1 (janvier 2014) : 134. http://dx.doi.org/10.1038/ajg.2013.388.

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