Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis
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To assess the value of the liver and spleen viscoelastic parameters at multifrequency MR elastography to determine the degree of portal hypertension and presence of high-risk oesophageal varices in patients with cirrhosis.
From January to September 2012, 36 consecutive patients with cirrhosis evaluated for transplantation were prospectively included. All patients underwent hepatic venous pressure gradient (HVPG) measurements and endoscopy to assess oesophageal varices. Multifrequency MR elastography was performed within the liver and spleen. The shear, storage and loss moduli were calculated and compared to the HVPG with Spearman coefficients and multiple regressions. Patients with and without severe portal hypertension and high-risk varices were compared with Mann–Whitney tests, logistic regression and ROC analysis.
The liver storage and loss moduli and the spleen shear, storage and loss moduli correlated with the HVPG. At multiple regression, only the liver and the spleen loss modulus correlated with the HVPG (r = 0.44, p = 0.017, and r = 0.57, p = 0.002, respectively). The spleen loss modulus was the best parameter for identifying patients with severe portal hypertension (p = 0.019, AUROC = 0.81) or high-risk varices (p = 0.042, AUROC = 0.93).
The spleen loss modulus appears to be the best parameter for identifying patients with severe portal hypertension or high-risk varices.
1. Noninvasive HVPG assessment can be performed with liver and spleen MR elastography
2. The spleen loss modulus enables the detection of high-risk oesophageal varices
3. The spleen loss modulus enables the detection of severe portal hypertension
KeywordsMR elastography Portal hypertension Oesophageal varices Spleen Liver
hepatic venous pressure gradient
complex shear modulus
international normalised ratio
area under the ROC curve
We thank Lucile Dehec, Ariane Metei, Maryse Moinat, Maryvonne Monroty and Irène Rua for their help in identifying the patients.
The scientific guarantor of this publication is Bernard E Van-Beers. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.
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