title: Liver and spleen stiffness in patients with extrahepatic portal vein obstruction.
abstract: OBJECTIVE
  To evaluate liver stiffness (LS) and spleen stiffness (SS) in patients with extrahepatic portal vein obstruction (EHPVO).
  
  
  METHODS
  Institutional research board approval and informed consent were obtained. LS and SS were measured in 65 consecutive patients with EHPVO. Patients underwent endoscopy, liver biopsy, liver function tests, abdominal ultrasonography, a detailed history, and examination. LS and SS measurements were also obtained in 50 age-matched healthy control subjects. Comparisons were made by using the Student t test, Mann-Whitney test for quantitative data, and χ(2) or Fisher exact test for qualitative data.
  
  
  RESULTS
  Sixty-five patients with EHPVO (with a bleed, n = 45; without a bleed, n = 20; mean age, 25.4 years ± 10.7 [standard deviation]; 29 men, 36 women) were enrolled. Twenty-two (34%) had hypersplenism. LS (P = .001) and SS (P = .01) were higher in patients with EHPVO (6.7 kPa ± 2.3 and 51.7 kPa ± 21.5, respectively) than in control subjects (4.6 kPa ± 0.7 and 16.0 kPa ± 3.0, respectively). Patients who had a bleed had higher SS than did those without a bleed (60.4 kPa ± 5.4 vs 30.3 kPa ± 14.2, P = .01). There was no significant difference in age (26.7 years ± 10.4 vs 22.5 years ± 9.8, P = .8) and median duration of disease (4.5 years [range, 1-26 years] vs 6.0 years [range, 1-22 years], P = .23) in patients with a bleed versus those without. With a cutoff of 5.9 kPa for LS, sensitivity and specificity for detection of a variceal bleed were 67% and 75%, respectively. An SS cutoff of 42.8 kPa yielded sensitivity and specificity of 88% and 94%, respectively.
  
  
  CONCLUSIONS
  LS and SS were higher in patients with EHPVO than in control subjects, and patients with a history of a bleed had a higher SS than did those without a bleed.
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India. drpraveen_sharma@yahoo.com
authors.forename: Praveen
authors.initials: P
authors.lastname: Sharma
authors.forename: Smruti Ranjan
authors.initials: SR
authors.lastname: Mishra
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Barjesh Chander
authors.initials: BC
authors.lastname: Sharma
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004724:Endoscopy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008111:Liver Function Tests; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*