2018 Volume 45 Issue 3 Pages 291-299
Purpose: The purpose of this study is to clarify the clinical usefulness of splenic elasticity measured with real-time tissue elastography (RTE) in chronic liver disease. Subjects and Methods: Subjects were 78 patients with various chronic liver disease. We measured splenic and liver elasticity with RTE and compared those to the size of the spleen (spleen index: SI), platelet count (PLT), AST to platelet ratio index (APRI), and the degree of portal hypertension measured by US, respectively. We also studied the relationship between splenic elasticity and the presence and degree of esophageal varices (EV) in 73 patients who had undergone upper gastrointestinal endoscopy, and then evaluated the potential of splenic elasticity for predicting EV and EV with red color sign (RC+). Results and Discussion: Splenic elasticity was well correlated with SI, PLT, APRI, liver elasticity, and the degree of portal hypertension. Splenic elasticity values were significantly increased in the EV+ group, especially in the EV/RC+ group. Splenic elasticity was superior to liver elasticity for predicting both EV (AUROC: 0.93, cutoff value of 72.2 with 84.6% sensitivity and 91.2% specificity) and EV/RC+ (AUROC: 0.81, cutoff value of 42.7 with 78.6% sensitivity and 81.0% specificity). Conclusion: Splenic elasticity measured with RTE is a good predictor of the degree of portal hypertension in chronic liver disease and could be a promising tool that allows us to predict the presence and degree of EV.
