title: Portal hypertension correlates with splenic stiffness as measured with MR elastography.
abstract: OBJECTIVE
  To investigate the correlation between MR elastography (MRE) assessed spleen stiffness and direct portal vein pressure gradient (D-HVPG) measurements in a large animal model of portal hypertension.
  
  
  METHODS
  Cholestatic liver disease was established in adult canines by common bile duct ligation. A spin echo based echo planar imaging (EPI) MRE sequence was used to acquire three-dimensional/three axis (3D/3-axis) abdominal MRE data at baseline, 4 weeks, and 8 weeks. Liver biopsies, blood samples, and D-HVPG measurements were obtained simultaneously.
  
  
  RESULTS
  Animals developed portal hypertension (D-HVPG: 11.0 ± 5.1 mmHg) with only F1 fibrosis after 4 weeks. F3 fibrosis was confirmed after 8 weeks despite no further rise in portal hypertension (D-HVPG: 11.3 ± 3.2 mmHg). Mean stiffnesses of the spleen increased over two-fold from baseline (1.72 ± 0.33 kPa) to 4 weeks (3.54 ± 0.31 kPa), and stabilized at 8 weeks (3.38 ± 0.06 kPa) in a pattern consistent with changes in portal pressure. A positive correlation was observed between spleen stiffness and D-HVPG (r(2) = 0.86; P < 0.01).
  
  
  CONCLUSIONS
  These findings indicate a temporal relationship between portal hypertension and the development of liver fibrosis in a large animal model of cholestatic liver disease. The observed direct correlation between spleen stiffness and D-HVPG suggest a noninvasive MRE approach to diagnose and screen for portal hypertension.
authors: Division of Transplantation Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
authors: Geir I
authors: GI
authors: Nedredal
authors: Meng
authors: M
authors: Yin
authors: Travis
authors: T
authors: McKenzie
authors: Joseph
authors: J
authors: Lillegard
authors: Jennifer
authors: J
authors: Luebke-Wheeler
authors: Jayant
authors: J
authors: Talwalkar
authors: Richard
authors: R
authors: Ehman
authors: Scott L
authors: SL
authors: Nyberg
references: J Hepatol. 1986;2(2):165-73
references: 3958472
references: J Hepatol. 2000;32(1 Suppl):141-56
references: 10728801
references: Hepatology. 2008 Jan;47(1):332-42
references: 18161879
references: Scand J Gastroenterol. 2008 Mar;43(3):328-33
references: 18938661
references: Hepatology. 2002 Jul;36(1):227-42
references: 12085369
references: Pathol Res Pract. 1984 Jul;178(6):590-4
references: 6483684
references: Hepatology. 2006 Feb;43(2 Suppl 1):S121-31
references: 16447289
references: Pathologica. 1993 Nov-Dec;85(1100):721-4
references: 8170720
references: Am J Gastroenterol. 2006 Mar;101(3):506-12
references: 16542287
references: Br J Surg. 1973 Aug;60(8):646-9
references: 4541913
references: Hepatology. 1994 Jul;20(1 Pt 1):15-20
references: 8020885
references: Hepatology. 1998 Dec;28(6):1467-73
references: 9828208
references: Gastroenterology. 2008 Jul;135(1):32-40
references: 18471441
references: N Engl J Med. 2001 Jul 5;345(1):41-52
references: 11439948
references: J Hepatol. 2000 Nov;33(5):846-52
references: 11097497
references: Pathol Int. 1994 Oct-Nov;44(10-11):753-8
references: 7834076
references: J Clin Invest. 1953 Oct;32(10):1025-33
references: 13096569
references: Gastroenterology. 2008 Jan;134(1):8-14
references: 18166342
references: Gastroenterology. 2008 Jul;135(1):299-302
references: 18555023
references: Clin Liver Dis. 2006 Aug;10(3):459-79, vii-viii
references: 17162223
references: Int J Exp Pathol. 2008 Aug;89(4):251-63
references: 18715470
references: Med Image Anal. 2001 Dec;5(4):237-54
references: 11731304
references: Hepatology. 1983 Nov-Dec;3(6):1002-7
references: 6629314
references: AJR Am J Roentgenol. 2009 Jul;193(1):122-7
references: 19542403
references: Hepatology. 2008 Nov;48(5):1718-23
references: 18836992
references: Am J Gastroenterol. 1996 Dec;91(12):2580-3
references: 8946990
references: Hepatology. 1997 Jan;25(1):2-5
references: 8985256
references: Med Image Anal. 2003 Dec;7(4):465-73
references: 14561551
references: Am J Vet Res. 1988 Mar;49(3):317-20
references: 3358542