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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 5
May  2023
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Current research status of spleen stiffness measurement in predicting portal hypertension and its complications in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.05.029
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  • Corresponding author: ZU Hongmei, 13997384855@163.com (ORCID: 0000-0002-7212-0891); ZHANG Jing, zjyouan@ccmu.edu.cn (ORCID: 0000-0002-3082-8330)
  • Received Date: 2022-09-07
  • Accepted Date: 2022-11-09
  • Published Date: 2023-05-20
  • Liver stiffness measurement (LSM) has been widely used in predicting portal hypertension in clinical practice, and in recent years, spleen stiffness measurement (SSM) has also become a diagnostic tool. Studies have shown that SSM can predict portal hypertension and its complications such as esophagogastric variceal bleeding in patients with chronic liver diseases and assist in the risk stratification management of portal hypertension and esophagogastric variceal bleeding. It can accurately predict clinically significant portal hypertension, high-risk esophageal and gastric varices, decompensation rate, and mortality rate in patients with chronic liver diseases. At present, SSM data in most studies are obtained by detection using the liver equipment FibroScan (SSM@50 Hz). FibroScan 630 is a new scanner dedicated for SSM with a special mode for SSM (SSM@100 Hz). This article elaborates on the significance of SSM in predicting portal hypertension and briefly introduces the advantages and disadvantages of the new equipment for SSM.

     

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  • [1]
    SIMONETTO DA, LIU M, KAMATH PS. Portal hypertension and related complications: diagnosis and management[J]. Mayoc Clin Proc, 2019, 94(4): 714-726. DOI: 10.1016/j.mayocp.2018.12.020.
    [2]
    HERNÁNDEZ-GEA V, BERBEL C, BAIGES A, et al. Acute variceal bleeding: risk stratification and management (including TIPS)[J]. J Hepatol Int, 2018, 12(Suppl 1): 81-90. DOI: 10.1007/s12072-017-9804-3.
    [3]
    RIZZO L, ATTANASIO M, PINZONE MR, et al. A new sampling method for spleen stiffness measurement based on quantitative acoustic radiation force impulse elastography for noninvasive assessment of esophageal varices in newly diagnosed HCV-related cirrhosis[J]. Biomed Res Int, 2014: 365982. DOI: 10.1155/2014/365982.
    [4]
    de FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno Ⅶ - Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76(4): 959-974. DOI: 10.1016/j.jhep.2021.12.022.
    [5]
    DAMICO G, PASTA L, MORABITO A, et al: Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients[J]. Aliment Pharmacol Ther, 2014, 39(10): 1180-1193. DOI: 10.1111/apt.12721.
    [6]
    de FRANCHIS R, Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno Ⅵ Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015, 63(3): 743-752. DOI: 10.1016/j.jhep.2015.05.022.
    [7]
    PAPATHEODORIDI M, HIRIART JB, LUPSOR-PLATON M, et al. Refining the Baveno Ⅵ elastography criteria for the definition of compensated advanced chronic liver disease[J]. J Hepatol, 2021, 74(5): 1109-1116. DOI: 10.1016/j.jhep.2020.11.050.
    [8]
    ABRALDES JG, BUREAU C, STEFANESCU H, et al. Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The "Anticipate" study[J]. J Hepatology, 2016, 64(6): 2173-2184. DOI: 10.1002/hep.28824.
    [9]
    STAFYLIDOU M, PASCHOS P, KATSOULA A, et al. Performance of Baveno Ⅵ and expanded Baveno Ⅵ criteria for excluding high-risk varices in patients with chronic liver diseases: a systematic review and Meta-analysis[J]. Clin Gastroenterol Hepatol, 2019, 17(9): 1744-1755. DOI: 10.1016/j.cgh.2019.04.062.
    [10]
    KIM BK, HAN KH, PARK JY, et al. A liver stiffness measurement-based, noninvasive prediction model for high-risk esophageal varices in B-viral liver cirrhosis[J]. Am J Gastroenterol, 2010, 105(6): 1382-1390. DOI: 10.1038/ajg.2009.750.
    [11]
    DENG H, QI X, GUO X. Diagnostic accuracy of APRI, AAR, FIB-4, FI, King, Lok, Forns, and FibroIndex Scores in predicting the presence of esophageal varices in liver cirrhosis: A systematic review and Meta-analysis[J]. Medicine (Baltimore), 2015, 94(42): e1795. DOI: 10.1097/MD.0000000000001795.
    [12]
    SHI KQ, FAN YC, PAN ZZ, et al. Transient elastography: a meta-analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease[J]. Liver Int, 2013, 33(1): 62-71. DOI: 10.1111/liv.12003.
    [13]
    HOU FF, QI XS, GUO XZ. Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement[J]. J Clin Hepatol, 2015, 31(9): 1384-1388. DOI: 10.3969/j.issn.1001-5256.2015.09.005.

    侯飞飞, 祁兴顺, 郭晓钟. 《2015年美国超声放射医师学会共识声明: 弹性成像评估肝纤维化》摘译[J]. 临床肝胆病杂志, 2015, 31(9): 1384-1388. DOI: 10.3969/j.issn.1001-5256.2015.09.005.
    [14]
    BOLOGNESI M, MERKEL C, SACERDOTI D, et al. Role of spleen enlargement in cirrhosis with portal hypertension[J]. Dig Liver Dis, 2002, 34(2): 144-150. DOI: 10.1016/s1590-8658(02)80246-8.
    [15]
    RIVA MA, FERRAINA F, PALEARI A, et al. From sadness to stiffness: the spleen's progress[J]. Intern Emerg Med, 2019, 14(5): 739-743. DOI: 10.1007/s11739-019-02115-2.
    [16]
    LI L, DUAN M, CHEN W, et al. The spleen in liver cirrhosis: revisiting an old enemy with novel targets[J]. J Transl Med, 2017, 15(1): 111. DOI: 10.1186/s12967-017-1214-8.
    [17]
    ELKRIEF L, RAUTOU PE, RONOT M, et al. Prospective comparison of spleen and liver stiffness by using shear-wave and transient elastography for detection of portal hypertension in cirrhosiss[J]. Radiology, 2015, 275(2): 589-598. DOI: 10.1148/radiol.14141210.
    [18]
    ROCCARINA D, ROSSELLI M, GENESCA J, et al. Elastography methods for the non-invasive assessment of portal hypertension[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(2): 155-164. DOI: 10.1080/17474124.2017.1374852.
    [19]
    DENG H, QI X, ZHANG T, et al. Supersonic shear imaging for the diagnosis of liver fibrosis and portal hypertension in liver diseases: a meta-analysis[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(1): 91-98. DOI: 10.1080/17474124.2018.1412257.
    [20]
    ZHANG XF, CHEN JJ. Advances and challenges in cirrhotic portal hypertension: A new start from the Baveno Ⅶ consensus[J]. J Clin Hepatol, 2022, 38(6): 1217-1219. DOI: 10.3969/j.issn.1001-5256.2022.06.001.

    张晓丰, 陈金军. 肝硬化门静脉高压的进展及挑战: 以BavenoⅦ共识为新起点[J]. 临床肝胆病杂志, 2022, 38(6): 1217-1219. DOI: 10.3969/j.issn.1001-5256.2022.06.001.
    [21]
    KIM HY, JIN EH, KIM W, et al. The role of spleen stiffness in determining the severity and bleeding risk of esophageal varices in cirrhotic patient[J]. Medicine (Baltimore), 2015, 94(24): e1031. DOI: 10.1097/MD.0000000000001031.
    [22]
    BUECHTER M, MANKA P, THEYSOHN JM, et al. Spleen stiffness is positively correlated with HVPG and decreases significantly after TIPS implantations[J]. Dig Liver Dis, 2018, 50(1): 54-60. DOI: 10.1016/j.dld.2017.09.138.
    [23]
    WONG G, KWOK R, HUI AJ, et al. A new screening strategy for varices by liver and spleen stiffness measurement (LSSM) in cirrhotic patients: A randomized trial[J]. Liver Int, 2018, 38(4): 636-644. DOI: 10.1111/liv.13560.
    [24]
    WONG GL, KWOK R, CHAN HL, et al. Measuring spleen stiffness to predict varices in chronic hepatitis B cirrhotic patients with or without receiving non-selective beta-blockerss[J]. J Dig Dis, 2016, 17(8): 538-546. DOI: 10.1111/1751-2980.12359.
    [25]
    SHIBATA S, UMEMURA T, YAMAZAKI T, et al. Liver stiffness-spleen size-to-platelet ratio risk score identifies esophageal varices in Japanese patients with chronic hepatitis C[J]. Hepatol Res, 2016, 46(9): 884-889. DOI: 10.1111/hepr.12631.
    [26]
    MA X, WANG L, WU H, et al. Spleen stiffness is superior to liver stiffness for predicting esophageal varices in chronic liver disease: A Meta-analysis[J]. PLoS One, 2016, 11(11): e0165786. DOI: 10.1371/journal.pone.0165786.
    [27]
    SHARMA P, KIRNAKE V, TYAGI P, et al. Spleen stiffness in patients with cirrhosis in predicting esophageal varices[J]. Am J Gastroenterol, 2013, 108(7): 1101-1107. DOI: 10.1038/ajg.2013.119.
    [28]
    CALÈS P, BUISSON F, RAVAIOLI F, et al. How to clarify the Baveno Ⅵ criteria for ruling out varices needing treatment by noninvasive tests[J]. Liver Int, 2019, 39(1): 49-53. DOI: 10.1111/liv.13945.
    [29]
    VIZZUTTI F, ARENA U, ROMANELLI RG, et al. Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis[J]. Hepatology, 2007, 45(5): 1290-1297. DOI: 10.1002/hep.21665.
    [30]
    SHARMA P, MISHRA SR, KUMAR M, et al. Liver and spleen stiffness in patients with extrahepatic portal vein obstruction[J]. Radiology, 2012, 263(3): 893-899. DOI: 10.1148/radiol.12111046.
    [31]
    MORISAKA H, MOTOSUGI U, ICHIKAWA S, et al. Association of splenic MR elastographic findings with gastroesophageal varices in patients with chronic liver disease[J]. J Magn Reson Imaging, 2015, 41(1): 117-124. DOI: 10.1002/jmri.24505.
    [32]
    STEFANESCU H, MARASCO G, CALÈS P, et al. A novel spleen-dedicated stiffness measurement by FibroScan improves the screening of high-risk oesophageal varices[J]. Liver Int, 2020, 40(1): 175-185. DOI: 10.1111/liv.14228.
    [33]
    BASTARD C, MIETTE V, CALÈS P, et al. A Novel FibroScan examination dedicated to spleen stiffness measurement[J]. Ultrasound Med Biol, 2018, 44(8): 1616-1626. DOI: 10.1016/j.ultrasmedbio.2018.03.028.
    [34]
    COLECCHIA A, COLLI A, CASAZZA G, et al. Spleen stiffness measurement can predict clinical complications in compensated HCV-related cirrhosis: A prospective studyt[J]. J Hepatol, 2014, 60(6): 1158-1164. DOI: 10.1016/j.jhep.2014.02.024.
    [35]
    MARASCO G, COLECCHIA A, DAJTI E, et al. Prediction of posthepatectomy liver failure: Role of SSM and LSPS[J]. J Surg Oncol, 2019, 119(3): 400-401. DOI: 10.1002/jso.25345.
    [36]
    CHIN JL, CHAN G, RYAN JD, et al. Spleen stiffness can non-invasively assess resolution of portal hypertension after liver transplantation[J]. Liver Int, 2015, 35(2): 518-523. DOI: 10.1111/liv.12647.
    [37]
    RAVAIOLI F, COLECCHIA A, DAJTI E, et al. Spleen stiffness mirrors changes in portal hypertension after successful interferon-free therapy in chronic-hepatitis C virus patients[J]. World J Hepatol, 2018, 10(10): 731-742. DOI: 10.4254/wjh.v10.i10.731.
    [38]
    DAJTI E, RAVAIOLI F, COLECCHIA A, et al. Spleen stiffness measurements predict the risk of hepatic decompensation after direct-acting antivirals in HCV cirrhotic patients[J]. Ultraschall Med, 2022, 43(3): 280-288. DOI: 10.1055/a-1205-0367.
    [39]
    MARASCO G, DAJTI E, RAVAIOLI F, et al. Spleen stiffness measurement for assessing the response to β-blockers therapy for high-risk esophageal varices patientss[J]. Hepatol Int, 2020, 14(5): 850-857. DOI: 10.1007/s12072-020-10062-w.
    [40]
    KIM HY, SO YH, KIM W, et al. Non-invasive response prediction in prophylactic carvedilol therapy for cirrhotic patients with esophageal varices[J]. J Hepatol, 2019, 70(3): 412-422. DOI: 10.1016/j.jhep.2018.10.018.
    [41]
    GUO J, BVNING C, SCHOTT E, et al. In vivo abdominal magnetic resonance elastography for the assessment of portal hypertension before and after transjugular intrahepatic portosystemic shunt implantation[J]. Invest Radiol, 2015, 50(5): 347-351. DOI: 10.1097/RLI.0000000000000136.
    [42]
    WANG L, SONG QK, YUE ZD, et al. Study on the correlation between PPG and HVPG in patients with portal hypertension [J]. Chin J Liver Dis, 2022, 30(7): 722-727. DOI: 10.3760/cma.j.cn501113-2020603-00291.

    王磊, 宋清坤, 岳振东, 等. 门静脉高压患者PPG与HVPG相关性研究[J]. 中华肝脏病杂志, 2022, 30(7): 722-727. DOI: 10.3760/cma.j.cn501113-20200603-00291.
    [43]
    TAKUMA Y, MORIMOTO Y, TAKABATAKE H, et al. Measurement of spleen stiffness with acoustic radiation force impulse imaging predicts mortality and hepatic decompensation in patients with liver cirrhosis[J]. Clin Gastroenterol Hepatol, 2017, 15(11): 1782-1790. DOI: 10.1016/j.cgh.2016.10.041.
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