Document Detail

Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis.
MedLine Citation:
PMID:  22643348     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: The hepatic vein pressure gradient (HVPG) is the standard used to determine the degree of portal hypertension (PH) and an important prognostic factor for patients with cirrhosis; HVPG values correlate with the presence of esophageal varices (EV). However, HVPG can only be accurately determined at specialized centers; noninvasive methods are needed to predict HVPG values and the presence of EV. We compared the diagnostic performance of spleen stiffness (SS) measurement by transient elastography with that of liver stiffness (LS) and of other recently proposed noninvasive tests.
METHODS: We measured SS and LS in 100 consecutive patients with hepatitis C virus-induced cirrhosis. Patients were also assessed by FibroScan, HVPG, esophagogastroduodenoscopy, and liver biopsy. We also analyzed LS-spleen diameter to platelet ratio score and platelet count to spleen diameter.
RESULTS: SS and LS were more accurate than other noninvasive parameters in identifying patients with EV and different degrees of PH. A linear model that included SS and LS accurately predicted HVPG values (R(2) = 0.85). The results were internally validated using bootstrap analysis.
CONCLUSIONS: Measurement of SS can be used for noninvasive assessment and monitoring of PH and to detect EV in patients with hepatitis C virus-induced cirrhosis.
Antonio Colecchia; Lucia Montrone; Eleonora Scaioli; Maria Letizia Bacchi-Reggiani; Agostino Colli; Giovanni Casazza; Ramona Schiumerini; Laura Turco; Anna Rita Di Biase; Giuseppe Mazzella; Luca Marzi; Umberto Arena; Massimo Pinzani; Davide Festi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-05-27
Journal Detail:
Title:  Gastroenterology     Volume:  143     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-11-06     Revised Date:  2013-04-10    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-54     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
Department of Clinical Medicine, University of Bologna, Bologna, Italy.
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MeSH Terms
Aged, 80 and over
Blood Pressure Determination
Chi-Square Distribution
Elasticity Imaging Techniques*
Endoscopy, Gastrointestinal
Esophageal and Gastric Varices / diagnosis*,  pathology,  virology
Hepatitis C / complications*
Hypertension, Portal / diagnosis*,  pathology,  physiopathology,  virology
Linear Models
Liver / blood supply,  pathology*,  virology
Liver Cirrhosis / virology*
Middle Aged
Platelet Count
Portal Pressure
Predictive Value of Tests
Sensitivity and Specificity
Severity of Illness Index
Spleen / pathology*
Splenomegaly / diagnosis*,  pathology,  virology
Comment In:
Hepatology. 2013 Mar;57(3):1278-80   [PMID:  23339063 ]
Gastroenterology. 2012 Oct;143(4):e23; author reply e23-4   [PMID:  22921672 ]

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