Jaehyung Park, Presenter: Nothing to Disclose

Kwon Hee-jin, Abstract Co-Author: Nothing to Disclose

Kyungjae Lim, Abstract Co-Author: Nothing to Disclose

Jinhan Cho, Abstract Co-Author: Nothing to Disclose

Jong-Young Oh, Abstract Co-Author: Nothing to Disclose

Kyung Jin Nam MD, Abstract Co-Author: Nothing to Disclose

Purpose: This study aimed to evaluate the accuracy of liver elastography, spleen elastography, and other noninvasive tests (aspartate aminotransferase-alanine aminotransferase ratio, APRI (AST platelet ratio) score, platelet count, and platelet/spleen ratio) in predicting the presence of esophageal varices in liver cirrhosis.

We studied 197 consecutive patients with hepatitis B virus (HBV) (n = 97), hepatitis C virus (HCV) (n = 59), or alcohol-induced liver cirrhosis (n = 41) who underwent biochemical tests, gastrointestinal endoscopy, and liver and spleen elastography by acoustic radiation force impulse (ARFI). The median liver and spleen stiffness values from 5 successful measurements per participant were obtained.  

Result: Among the patients with a valid measurement, 43 % had no esophageal varices, whereas the others had esophageal varices. On univariate analysis, the platelet count, platelet/spleen ratio, and spleen elastography were independently associated with esophageal varices. However, in cases of alcohol-induced liver cirrhosis, spleen stiffness was not reliable for prediction of esophageal varices and also spleen stiffness measurement are less reproducible than liver stiffness measurement.  

Conclusion: The liver and spleen stiffness values measured by ARFI elastography are well correlated, and spleen stiffness measured by ARFI can potentially be used as a non-invasive method for determining the presence of esophageal varices. However, the evidence supporting a similar role for replacing endoscopy is lacking because spleen stiffness is less reproducible compared to liver stiffness and, further, it is not an appropriate predictor for esophageal varices in alcoholic cirrhosis.

Spleen stiffness is potentially good predictor for esophageal varix, but the measurement are less reproducible than liver stiffness.

Park, J, Hee-jin, K, Lim, K, Cho, J, Oh, J, Nam, K, Comparison of the Accuracy between Liver and Spleen Elastography Using Acoustic Radiation Force Impulse and Other Noninvasive Tests in Predicting the Presence of Esophageal Varices.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006994.html