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01-06-2014 | Hepatobiliary-Pancreas

Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis

Authors: Maxime Ronot, Simon Lambert, Laure Elkrief, Sabrina Doblas, Pierre-Emmanuel Rautou, Laurent Castera, Valérie Vilgrain, Ralph Sinkus, Bernard E. Van Beers, Philippe Garteiser

Published in: European Radiology | Issue 6/2014

Abstract

Objective

To assess the value of the liver and spleen viscoelastic parameters at multifrequency MR elastography to determine the degree of portal hypertension and presence of high-risk oesophageal varices in patients with cirrhosis.

Methods

From January to September 2012, 36 consecutive patients with cirrhosis evaluated for transplantation were prospectively included. All patients underwent hepatic venous pressure gradient (HVPG) measurements and endoscopy to assess oesophageal varices. Multifrequency MR elastography was performed within the liver and spleen. The shear, storage and loss moduli were calculated and compared to the HVPG with Spearman coefficients and multiple regressions. Patients with and without severe portal hypertension and high-risk varices were compared with Mann–Whitney tests, logistic regression and ROC analysis.

Results

The liver storage and loss moduli and the spleen shear, storage and loss moduli correlated with the HVPG. At multiple regression, only the liver and the spleen loss modulus correlated with the HVPG (r = 0.44, p = 0.017, and r = 0.57, p = 0.002, respectively). The spleen loss modulus was the best parameter for identifying patients with severe portal hypertension (p = 0.019, AUROC = 0.81) or high-risk varices (p = 0.042, AUROC = 0.93).

Conclusions

The spleen loss modulus appears to be the best parameter for identifying patients with severe portal hypertension or high-risk varices.

Key points

1. Noninvasive HVPG assessment can be performed with liver and spleen MR elastography

2. The spleen loss modulus enables the detection of high-risk oesophageal varices

3. The spleen loss modulus enables the detection of severe portal hypertension

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Title: Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis
Authors: Maxime Ronot
Simon Lambert
Laure Elkrief
Sabrina Doblas
Pierre-Emmanuel Rautou
Laurent Castera
Valérie Vilgrain
Ralph Sinkus
Bernard E. Van Beers
Philippe Garteiser
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3124-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis

Abstract

Objective

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key points

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