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European Radiology
Published in: European Radiology 12/2022

21-06-2022 | Hypertension | Hepatobiliary-Pancreas

MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension

Authors: Paul Kennedy, Daniel Stocker, Guillermo Carbonell, Daniela Said, Octavia Bane, Stefanie Hectors, Ghadi Abboud, Jordan Cuevas, Bradley D. Bolster Jr, Scott L. Friedman, Sara Lewis, Thomas Schiano, Dipankar Bhattacharya, Aaron Fischman, Swan Thung, Bachir Taouli

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

Portal hypertension (PH) is associated with complications such as ascites and esophageal varices and is typically diagnosed through invasive hepatic venous pressure gradient (HVPG) measurement, which is not widely available. In this study, we aim to assess the diagnostic performance of 2D/3D MR elastography (MRE) and shear wave elastography (SWE) measures of liver and spleen stiffness (LS and SS) and spleen volume, to noninvasively diagnose clinically significant portal hypertension (CSPH) using HVPG measurement as the reference.

Methods

In this prospective study, patients with liver disease underwent 2D/3D MRE and SWE of the liver and spleen, as well as HVPG measurement. The correlation between MRE/SWE measures of LS/SS and spleen volume with HVPG was assessed. ROC analysis was used to determine the utility of MRE, SWE, and spleen volume for diagnosing CSPH.

Results

Thirty-six patients (M/F 22/14, mean age 55 ± 14 years) were included. Of the evaluated parameters, 3D MRE SS had the strongest correlation with HVPG (r = 0.686, p < 0.001), followed by 2D MRE SS (r = 0.476, p = 0.004). 3D MRE SS displayed the best performance for diagnosis of CSPH (AUC = 0.911) followed by 2D MRE SS (AUC = 0.845) and 3D MRE LS (AUC = 0.804). SWE SS showed poor performance for diagnosis of CSPH (AUC = 0.583) while spleen volume was a fair predictor (AUC = 0.738). 3D MRE SS was significantly superior to SWE LS/SS (p ≤ 0.021) for the diagnosis of CSPH.

Conclusion

SS measured with 3D MRE outperforms SWE for the diagnosis of CSPH. SS appears to be a useful biomarker for assessing PH severity. These results need further validation.

Key Points

• Spleen stiffness measured with 2D and 3D MR elastography correlates significantly with hepatic venous pressure gradient measurement.
• Spleen stiffness measured with 3D MR elastography demonstrates excellent performance for the diagnosis of clinically significant portal hypertension (AUC 0.911).
• Spleen stiffness measured with 3D MR elastography outperforms liver and spleen stiffness measured with shear wave elastography for diagnosis of clinically significant portal hypertension.
Appendix
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Metadata
Title
MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension
Authors
Paul Kennedy
Daniel Stocker
Guillermo Carbonell
Daniela Said
Octavia Bane
Stefanie Hectors
Ghadi Abboud
Jordan Cuevas
Bradley D. Bolster Jr
Scott L. Friedman
Sara Lewis
Thomas Schiano
Dipankar Bhattacharya
Aaron Fischman
Swan Thung
Bachir Taouli
Publication date
21-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08935-9

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