Liver and Spleen Stiffness
in Patients with Extrahepatic Portal Vein Obstruction
Purpose: To evaluate liver
stiffness (LS) and spleen stiffness (SS) in patients with extrahepatic portal
vein obstruction (EHPVO).
Materials and Methods:
Institutional research board approval and informed consent were obtained. LS
and SS were measured in 65 consecutive patients with EHPVO. Patients underwent
endoscopy, liver biopsy, liver function tests, abdominal ultrasonography, a
detailed history, and examination. LS and SS measurements were also obtained in
50 age-matched healthy control subjects. Comparisons were made by using the
Student t test, Mann-Whitney test for quantitative data,
and χ2 or Fisher exact test for qualitative data.
Results: Sixty-five
patients with EHPVO (with a bleed, n = 45; without a bleed, n
= 20; mean age, 25.4 years ± 10.7 [standard deviation]; 29 men, 36 women) were
enrolled. Twenty-two (34%) had hypersplenism. LS (P = .001) and SS (P = .01) were higher in patients with EHPVO (6.7
kPa ± 2.3 and 51.7 kPa ± 21.5, respectively) than in control subjects (4.6 kPa
± 0.7 and 16.0 kPa ± 3.0, respectively). Patients who had a bleed had higher SS
than did those without a bleed (60.4 kPa ± 5.4 vs 30.3 kPa ± 14.2, P = .01). There was no significant difference in
age (26.7 years ± 10.4 vs 22.5 years ± 9.8, P = .8) and median duration of disease (4.5 years
[range, 1–26 years] vs 6.0 years [range, 1–22 years], P = .23) in patients with a bleed versus those
without. With a cutoff of 5.9 kPa for LS, sensitivity and specificity for
detection of a variceal bleed were 67% and 75%, respectively. An SS cutoff of
42.8 kPa yielded sensitivity and specificity of 88% and 94%, respectively.
Conclusion: LS and SS
were higher in patients with EHPVO than in control subjects, and patients with
a history of a bleed had a higher SS than did those without a bleed.
© RSNA, 2012
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