title: ARFI elastography of the spleen is inferior to liver elastography for the detection of portal hypertension.
abstract: OBJECTIVE
  To date, the use of transient elastography has been limited to the liver. Acoustic radiation force impulse imaging (ARFI) is a new technology offering elastography of different tissues. Here, we present initial spleen elastography data and evaluate its influencing factors, especially portal hypertension.
  
  
  METHODS
  Elastography of the spleen and liver using the ARFI method was performed in 30 patients with portal hypertension, 70 patients with chronic liver disease without portal hypertension and 25 healthy controls.
  
  
  RESULTS
  ARFI elastography of the spleen was feasible in 99% of patients and valid in 78%. The mean propagation velocity inside the spleen was 2.95 ± 0.60 m/sec, thus much higher than in the normal liver (< 1.10 m/sec). Spleen stiffness was higher in the patients with portal hypertension (p < 0.008) but did not correlate to spleen size. Spleen stiffness increased with patient age and liver stiffness (both p < 0.0001) as confirmed by multivariate analysis (R2 = 0.19, p < 0.01). In ROC analysis, spleen elastography was inferior to liver elastography for the detection of portal hypertension (area under the curve 0.68 vs. 0.90).
  
  
  CONCLUSIONS
  The new ARFI method allows accurate elastography of the spleen. The stiffness of the normal spleen is much higher than that of the normal liver and increases with age. However, spleen elastography is inferior to liver elastography for the detection of portal hypertension.
authors.affiliation: Gastroenterology and Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. rifai.k@gmx.de
authors.forename: K
authors.initials: K
authors.lastname: Rifai
authors.forename: J
authors.initials: J
authors.lastname: Cornberg
authors.forename: M
authors.initials: M
authors.lastname: Bahr
authors.forename: I
authors.initials: I
authors.lastname: Mederacke
authors.forename: A
authors.initials: A
authors.lastname: Potthoff
authors.forename: H
authors.initials: H
authors.lastname: Wedemeyer
authors.forename: M
authors.initials: M
authors.lastname: Manns
authors.forename: M
authors.initials: M
authors.lastname: Gebel
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging*