Correlation of Spleen Stiffness by Transient Elastrography with Parameters of Indicated Portal Hypertension and the Presence of Esophageal Varices
Patcharaporn Paocharern MD1, Supatsri Sethasine MD1
Affiliation : 1 Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background : Portal hypertension is a complication of cirrhosis, which causes esophageal varices [EV], splenomegaly,
ascites and hepatic encephalopathy. The gold standard for diagnosis of portal hypertension is hepatic venous pressure
gradient [HVPG] measurement, which is not routinely performed in every hospital. There is evidence that the spleen
stiffness value correlates with the HVPG.
Objective : To study the relationship between spleen stiffness and parameters of indicated portal hypertension and study the
relationship between spleen stiffness and the presence of EV.
Materials and Methods : Thirty-eight patients with clinical signs or any indicators of cirrhotic portal hypertension were
evaluated by measuring splenic diameter and portal vein diameter by ultrasound. The authors measured liver and spleen
stiffness using transient elastrography and upper endoscopy for the diagnosis of EV.
Results : Spleen stiffness showed no significant correlation between groups indicated portal hypertension. Sixteen patients,
in a group which had the highest median value of spleen stiffness, had EV (75%). The present study found 81.5% of all
patients had EV; EV group tend to have higher median spleen stiffness values than those without EV, although this is not
statistically significant (54.2 vs. 49.6 kPa, p = 0.38). Integrating liver stiffness value, splenic diameter and platelet count in
terms of LSPS score, showed that LSPS score was significantly higher in the EV group (6.89 vs. 1.72, p = 0.011).
Conclusion : LSPS score, but not spleen stiffness was a good non-invasive measurement for predicting portal hypertension
in terms of the presence of esophageal varices.
Keywords : Esophageal varices, Portal hypertension, Spleen stiffness
