Spleen stiffness measurement as a non-invasive test to evaluate and monitor portal hypertension in children with extrahepatic portal vein obstruction

• Published in: Pediatric surgery international 2020-05, Vol.36 (5), p.637-641
• Main Authors: Yuldashev, R. Z., Aliev, M. M., Shokhaydarov, Sh. I., Tursunova, D. B.
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Age; Child; Child, Preschool; Computed Tomography Angiography; Constriction, Pathologic; Elasticity; Elasticity Imaging Techniques - methods; Endoscopy; Endoscopy, Digestive System; Esophagus; Female; Humans; Hypertension; Hypertension, Portal - diagnosis; Hypertension, Portal - physiopathology; Hypertension, Portal - surgery; Liver; Male; Medical imaging; Medicine; Medicine & Public Health; Monitoring, Physiologic - methods; Original Article; Pediatric Surgery; Pediatrics; Portal Vein - diagnostic imaging; Portal Vein - surgery; Portasystemic Shunt, Surgical; Spleen; Spleen - diagnostic imaging; Spleen - physiopathology; Surgery; Thrombosis; Ultrasonic imaging; Vascular Diseases - diagnosis; Vascular Diseases - surgery; Veins & arteries
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-020-04648-6

Purpose The aim of the study was to test the feasibility of spleen stiffness measurement (SSM) by two-dimensional shear wave elastography (2D-SWE) and compare data on its diagnostic use with upper gastrointestinal endoscopy in children with extrahepatic portal hypertension (EHPH) before and after surgery. Methods A total of 44 children were included in this study [34 children with EHPH (main group)] and 10 controls (7.57 ± 1.22 years), who underwent ultrasonography including SSM by 2D-SWE. Patients in the main group also underwent upper gastrointestinal endoscopy (UGE) and CT angiography. The main group was divided into three subgroups: Group A: patients with EHPH without large spontaneous portosystemic shunts ( n  = 15); Group B: patients with EHPH with large spontaneous portosystemic shunts ( n  = 9); Group C: patients with EHPVO and after surgical portosystemic shunts ( n  = 10). Results According to UGE, c hildren in group A had significantly higher grades of esophageal varices (EV) (2.3 ± 0.14; p