title: Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension.
abstract: OBJECTIVE
  Liver stiffness is associated with portal hypertension in patients with chronic liver disease. However, the relation between spleen stiffness and clinically significant portal hypertension remains unknown. The purposes of this study were to determine the feasibility of measuring spleen stiffness with MR elastography and to prospectively test the technique in healthy volunteers and in patients with compensated liver disease.
  
  
  METHODS
  Spleen stiffness was measured with MR elastography in 12 healthy volunteers (mean age, 37 years; range, 25-82 years) and 38 patients (mean age, 56 years; range, 36-60 years) with chronic liver disease of various causes. For patients with liver disease, laboratory findings, spleen size, presence and size of esophageal varices, and liver histologic results were recorded. Statistical analyses were performed to assess all measurements.
  
  
  RESULTS
  MR elastography of the spleen was successfully performed on all volunteers and patients. The mean spleen stiffness was significantly lower in the volunteers (mean, 3.6 +/- 0.3 kPa) than in the patients with liver fibrosis (mean, 5.6 +/- 5.0 kPa; range, 2.7-19.2 kPa; p < 0.001). In addition, a significant correlation was observed between liver stiffness and spleen stiffness for the entire cohort (r(2) = 0.75; p < 0.001). Predictors of spleen stiffness were splenomegaly, spleen volume, and platelet count. A mean spleen stiffness of 10.5 kPa or greater was identified in all patients with esophageal varices.
  
  
  CONCLUSIONS
  MR elastography of the spleen is feasible and shows promise as a quantitative method for predicting the presence of esophageal varices in patients with advanced hepatic fibrosis.
authors: Advanced Liver Diseases Study Group, Department of Gastroenterology and Hepatology, Miles and Shirley Fiterman Center for Digestive Diseases, Mayo Clinic, Rochester, MN, USA.
authors: Jayant A
authors: JA
authors: Talwalkar
authors: Meng
authors: M
authors: Yin
authors: Sudhakar
authors: S
authors: Venkatesh
authors: Phillip J
authors: PJ
authors: Rossman
authors: Roger C
authors: RC
authors: Grimm
authors: Armando
authors: A
authors: Manduca
authors: Anthony
authors: A
authors: Romano
authors: Patrick S
authors: PS
authors: Kamath
authors: Richard L
authors: RL
authors: Ehman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology / Q000503:physiopathology*; D013314:Stress, Mechanical