Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension

Jayant A. Talwalkar, Meng Yin, Sudhakar K Venkatesh, Phillip J. Rossman, Roger C. Grimm, Armando Manduca, Anthony Romano, Patrick Sequeira Kamath, Richard Lorne Ehman

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

OBJECTIVE. Liver stiffness is associated with portal hypertension in patients with chronic liver disease. However, the relation between spleen stiffness and clinically significant portal hypertension remains unknown. The purposes of this study were to determine the feasibility of measuring spleen stiffness with MR elastography and to prospectively test the technique in healthy volunteers and in patients with compensated liver disease. MATERIALS AND METHODS. Spleen stiffness was measured with MR elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years) and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver disease of various causes. For patients with liver disease, laboratory findings, spleen size, presence and size of esophageal varices, and liver histologic results were recorded. Statistical analyses were performed to assess all measurements. RESULTS. MR elastography of the spleen was successfully performed on all volunteers and patients. The mean spleen stiffness was significantly lower in the volunteers (mean, 3.6 ± 0.3 kPa) than in the patients with liver fibrosis (mean, 5.6 ± 5.0 kPa; range, 2.7-19.2 kPa; p < 0.001). In addition, a significant correlation was observed between liver stiffness and spleen stiffness for the entire cohort (r2 = 0.75; p < 0.001). Predictors of spleen stiffness were splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of 10.5 kPa or greater was identified in all patients with esophageal varices. CONCLUSION. MR elastography of the spleen is feasible and shows promise as a quantitative method for predicting the presence of esophageal varices in patients with advanced hepatic fibrosis.

Original languageEnglish (US)
Pages (from-to)122-127
Number of pages6
JournalAmerican Journal of Roentgenology
Volume193
Issue number1
DOIs
StatePublished - Jul 2009

Fingerprint

Portal Hypertension
Spleen
Elasticity Imaging Techniques
Esophageal and Gastric Varices
Liver Diseases
Liver
Volunteers
Healthy Volunteers
Chronic Disease
Splenomegaly
Platelet Count
Liver Cirrhosis
Fibrosis

Keywords

  • Esophageal varices
  • Liver fibrosis
  • MR elastography
  • Portal hypertension
  • Spleen stiffness

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. / Talwalkar, Jayant A.; Yin, Meng; Venkatesh, Sudhakar K; Rossman, Phillip J.; Grimm, Roger C.; Manduca, Armando; Romano, Anthony; Kamath, Patrick Sequeira; Ehman, Richard Lorne.

In: American Journal of Roentgenology, Vol. 193, No. 1, 07.2009, p. 122-127.

Research output: Contribution to journalArticle

@article{77270cb2069e4d608849a43224977a1b,
title = "Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension",
abstract = "OBJECTIVE. Liver stiffness is associated with portal hypertension in patients with chronic liver disease. However, the relation between spleen stiffness and clinically significant portal hypertension remains unknown. The purposes of this study were to determine the feasibility of measuring spleen stiffness with MR elastography and to prospectively test the technique in healthy volunteers and in patients with compensated liver disease. MATERIALS AND METHODS. Spleen stiffness was measured with MR elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years) and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver disease of various causes. For patients with liver disease, laboratory findings, spleen size, presence and size of esophageal varices, and liver histologic results were recorded. Statistical analyses were performed to assess all measurements. RESULTS. MR elastography of the spleen was successfully performed on all volunteers and patients. The mean spleen stiffness was significantly lower in the volunteers (mean, 3.6 ± 0.3 kPa) than in the patients with liver fibrosis (mean, 5.6 ± 5.0 kPa; range, 2.7-19.2 kPa; p < 0.001). In addition, a significant correlation was observed between liver stiffness and spleen stiffness for the entire cohort (r2 = 0.75; p < 0.001). Predictors of spleen stiffness were splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of 10.5 kPa or greater was identified in all patients with esophageal varices. CONCLUSION. MR elastography of the spleen is feasible and shows promise as a quantitative method for predicting the presence of esophageal varices in patients with advanced hepatic fibrosis.",
keywords = "Esophageal varices, Liver fibrosis, MR elastography, Portal hypertension, Spleen stiffness",
author = "Talwalkar, {Jayant A.} and Meng Yin and Venkatesh, {Sudhakar K} and Rossman, {Phillip J.} and Grimm, {Roger C.} and Armando Manduca and Anthony Romano and Kamath, {Patrick Sequeira} and Ehman, {Richard Lorne}",
year = "2009",
month = "7",
doi = "10.2214/AJR.07.3504",
language = "English (US)",
volume = "193",
pages = "122--127",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "1",

}

TY - JOUR

T1 - Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension

AU - Talwalkar, Jayant A.

AU - Yin, Meng

AU - Venkatesh, Sudhakar K

AU - Rossman, Phillip J.

AU - Grimm, Roger C.

AU - Manduca, Armando

AU - Romano, Anthony

AU - Kamath, Patrick Sequeira

AU - Ehman, Richard Lorne

PY - 2009/7

Y1 - 2009/7

N2 - OBJECTIVE. Liver stiffness is associated with portal hypertension in patients with chronic liver disease. However, the relation between spleen stiffness and clinically significant portal hypertension remains unknown. The purposes of this study were to determine the feasibility of measuring spleen stiffness with MR elastography and to prospectively test the technique in healthy volunteers and in patients with compensated liver disease. MATERIALS AND METHODS. Spleen stiffness was measured with MR elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years) and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver disease of various causes. For patients with liver disease, laboratory findings, spleen size, presence and size of esophageal varices, and liver histologic results were recorded. Statistical analyses were performed to assess all measurements. RESULTS. MR elastography of the spleen was successfully performed on all volunteers and patients. The mean spleen stiffness was significantly lower in the volunteers (mean, 3.6 ± 0.3 kPa) than in the patients with liver fibrosis (mean, 5.6 ± 5.0 kPa; range, 2.7-19.2 kPa; p < 0.001). In addition, a significant correlation was observed between liver stiffness and spleen stiffness for the entire cohort (r2 = 0.75; p < 0.001). Predictors of spleen stiffness were splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of 10.5 kPa or greater was identified in all patients with esophageal varices. CONCLUSION. MR elastography of the spleen is feasible and shows promise as a quantitative method for predicting the presence of esophageal varices in patients with advanced hepatic fibrosis.

AB - OBJECTIVE. Liver stiffness is associated with portal hypertension in patients with chronic liver disease. However, the relation between spleen stiffness and clinically significant portal hypertension remains unknown. The purposes of this study were to determine the feasibility of measuring spleen stiffness with MR elastography and to prospectively test the technique in healthy volunteers and in patients with compensated liver disease. MATERIALS AND METHODS. Spleen stiffness was measured with MR elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years) and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver disease of various causes. For patients with liver disease, laboratory findings, spleen size, presence and size of esophageal varices, and liver histologic results were recorded. Statistical analyses were performed to assess all measurements. RESULTS. MR elastography of the spleen was successfully performed on all volunteers and patients. The mean spleen stiffness was significantly lower in the volunteers (mean, 3.6 ± 0.3 kPa) than in the patients with liver fibrosis (mean, 5.6 ± 5.0 kPa; range, 2.7-19.2 kPa; p < 0.001). In addition, a significant correlation was observed between liver stiffness and spleen stiffness for the entire cohort (r2 = 0.75; p < 0.001). Predictors of spleen stiffness were splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of 10.5 kPa or greater was identified in all patients with esophageal varices. CONCLUSION. MR elastography of the spleen is feasible and shows promise as a quantitative method for predicting the presence of esophageal varices in patients with advanced hepatic fibrosis.

KW - Esophageal varices

KW - Liver fibrosis

KW - MR elastography

KW - Portal hypertension

KW - Spleen stiffness

UR - http://www.scopus.com/inward/record.url?scp=67650341226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650341226&partnerID=8YFLogxK

U2 - 10.2214/AJR.07.3504

DO - 10.2214/AJR.07.3504

M3 - Article

C2 - 19542403

AN - SCOPUS:67650341226

VL - 193

SP - 122

EP - 127

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 1

ER -