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Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objective

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.

Methods

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.

Results

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).

Conclusions

The spleen loss modulus appears to be the best parameter for identifying patients with severe portal hypertension or high-risk varices.

Key points

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

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Abbreviations

MR:

magnetic resonance

HVPG:

hepatic venous pressure gradient

G*:

complex shear modulus

Gd:

storage modulus

Gl:

loss modulus

ROC:

receiver-operating characteristics

INR:

international normalised ratio

GGT:

gamma-glutamyl transpeptidase

AP:

alkaline phosphatase

AST:

aspartate aminotransferase

ALT:

alanine aminotransferase

AUROC:

area under the ROC curve

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Acknowledgements

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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Authors and Affiliations

  1. Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, 100 Bd du Général Leclerc, 92110, Clichy, France

    Maxime Ronot, Valérie Vilgrain & Bernard E. Van Beers

  2. University Paris Diderot, Sorbonne Paris Cité, France

    Maxime Ronot, Simon Lambert, Laure Elkrief, Sabrina Doblas, Pierre-Emmanuel Rautou, Laurent Castera, Valérie Vilgrain, Ralph Sinkus, Bernard E. Van Beers & Philippe Garteiser

  3. INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France

    Maxime Ronot, Simon Lambert, Laure Elkrief, Sabrina Doblas, Pierre-Emmanuel Rautou, Laurent Castera, Valérie Vilgrain, Ralph Sinkus, Bernard E. Van Beers & Philippe Garteiser

  4. Department of Hepatology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France

    Laure Elkrief, Pierre-Emmanuel Rautou & Laurent Castera

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  1. Maxime Ronot
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Correspondence to Maxime Ronot.

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Ronot, M., Lambert, S., Elkrief, L. et al. Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis. Eur Radiol 24, 1394–1402 (2014). https://doi.org/10.1007/s00330-014-3124-y

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  • DOI: https://doi.org/10.1007/s00330-014-3124-y

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