title: Spleen assessment by Acoustic Radiation Force Impulse Elastography (ARFI) for prediction of liver cirrhosis and portal hypertension.
abstract: OBJECTIVE
  To establish the values of spleen stiffness (SS) assessed by Acoustic Radiation Force Impulse (ARFI) in healthy subjects and in cirrhotic patients, and to evaluate its predictive value for the presence of cirrhosis and for the presence and severity of esophageal varices (EV).
  
  
  METHODS
  Our study included 82 subjects (15 healthy volunteers, 57 cirrhotic patients, 10 with various grade of liver fibrosis), 38 women and 44 men. Of these, 42 cirrhotic patients had varices, 30 had significant EV and 11 had a history of variceal bleeding. We performed 10 measurements in each patient expressed in meters/second (m/s) and a median value was obtained.
  
  
  RESULTS
  The mean SS values (m/s) were: 2.04+/-0.28 in healthy subjects and 3.10+/-0.55 in cirrhotic patients (p<0.001). For a cut-off value of >2.51 m/s of SS, ARFI had 85.2% Se, 91.7% Sp, 95.8% PPV, 73.3% NPV, 87.1% accuracy (AUROC=0.91) for predincting liver cirrhosis. No significant differences regarding SS were observed between patients with and without EV, also between those with and without a history of variceal bleeding.
  
  
  CONCLUSIONS
  SS evaluated by means of ARFI had a very good predictive value for the presence of cirrhosis (AUROC=0.91, accuracy=87.1%), but could not predict the presence or severity of EV, also the risk of variceal bleeding.
authors.affiliation: Department of Gastroenterology and Hepatology University of Medicine and Pharmacy, Timişoara, România. bota_simona1982@yahoo.com
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Mirela
authors.initials: M
authors.lastname: Dănilă
authors.forename: Mădălina
authors.initials: M
authors.lastname: Sendroiu
authors.forename: Mircea
authors.initials: M
authors.lastname: Focşa
mesh_terms: D019540:Area Under Curve; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging*