title: Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis.
abstract: OBJECTIVE
  To assess the value of the liver and spleen viscoelastic parameters at multifrequency MR elastography to determine the degree of portal hypertension and presence of high-risk oesophageal varices in patients with cirrhosis.
  
  
  METHODS
  From January to September 2012, 36 consecutive patients with cirrhosis evaluated for transplantation were prospectively included. All patients underwent hepatic venous pressure gradient (HVPG) measurements and endoscopy to assess oesophageal varices. Multifrequency MR elastography was performed within the liver and spleen. The shear, storage and loss moduli were calculated and compared to the HVPG with Spearman coefficients and multiple regressions. Patients with and without severe portal hypertension and high-risk varices were compared with Mann-Whitney tests, logistic regression and ROC analysis.
  
  
  RESULTS
  The liver storage and loss moduli and the spleen shear, storage and loss moduli correlated with the HVPG. At multiple regression, only the liver and the spleen loss modulus correlated with the HVPG (r = 0.44, p = 0.017, and r = 0.57, p = 0.002, respectively). The spleen loss modulus was the best parameter for identifying patients with severe portal hypertension (p = 0.019, AUROC = 0.81) or high-risk varices (p = 0.042, AUROC = 0.93).
  
  
  CONCLUSIONS
  The spleen loss modulus appears to be the best parameter for identifying patients with severe portal hypertension or high-risk varices.
  
  
  CONCLUSIONS
  1. Noninvasive HVPG assessment can be performed with liver and spleen MR elastography 2. The spleen loss modulus enables the detection of high-risk oesophageal varices 3. The spleen loss modulus enables the detection of severe portal hypertension.
authors.affiliation: Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, 100 Bd du Général Leclerc, 92110, Clichy, France, maxime.ronot@bjn.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.forename: Simon
authors.initials: S
authors.lastname: Lambert
authors.forename: Laure
authors.initials: L
authors.lastname: Elkrief
authors.forename: Sabrina
authors.initials: S
authors.lastname: Doblas
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Rautou
authors.forename: Laurent
authors.initials: L
authors.lastname: Castera
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Ralph
authors.initials: R
authors.lastname: Sinkus
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Van Beers
authors.forename: Philippe
authors.initials: P
authors.lastname: Garteiser
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000473:pathology*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D013154:Spleen / Q000473:pathology