Modified spleen stiffness measurement by transient elastography is associated with presence of large oesophageal varices in patients with compensated hepatitis C virus cirrhosis

• Published in: Journal of viral hepatitis 2013-12, Vol.20 (12), p.867-874
• Main Authors: Calvaruso, V., Bronte, F., Conte, E., Simone, F., Craxì, A., Di Marco, V.
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Biomarkers; cirrhosis; Elasticity Imaging Techniques - methods; Esophageal and Gastric Varices - diagnosis; Female; Fibrosis; Hepatitis C virus; Hepatitis C, Chronic - complications; Humans; Liver Cirrhosis - complications; liver stiffness; Male; Middle Aged; oesophageal varices; Prospective Studies; ROC Curve; Sensitivity and Specificity; Spleen - pathology; spleen stiffness; transient elastography; Varicose Veins
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/jvh.12114

Summary To evaluate the accuracy of liver transient elastography (TE), spleen TE and other noninvasive tests (AAR, APRI score, platelet count, platelet/spleen ratio) in predicting the presence and the size of oesophageal varices in compensated hepatitis C virus (HCV) cirrhosis, we studied 112 consecutive patients with compensated HCV cirrhosis who underwent biochemical tests, gastrointestinal endoscopy, liver TE and spleen TE by Fibroscan® (Echosens, Paris, France) using a modified software version with a range between 1.5 and 150 kPa. Spleen TE was not reliable in 16 patients (14.3%). Among the 96 patients with a valid measurement (69.8% men, mean age: 63.2 ± 9.5 years), 43.7% had no oesophageal varices, 29.2% had grade 1% and 27.1% had grade 2 or grade 3 oesophageal varices. Patients with values of 75 kPa by standard spleen TE had mean values of modified spleen TE of 117 kPa (range: 81.7–149.5). Linear regression revealed a significant correlation between modified spleen TE and oesophageal varix size (r = 0.501; beta: 0.763, SE: 0.144; P