title: Prospective comparison of spleen and liver stiffness by using shear-wave and transient elastography for detection of portal hypertension in cirrhosis.
abstract: OBJECTIVE
  To prospectively compare the technical success rate and accuracy of shear-wave elastography (SWE) and transient elastography (TE) for the detection of clinically significant portal hypertension (PH) in patients with advanced cirrhosis who are undergoing hepatic vein pressure gradient (HVPG) measurements.
  
  
  METHODS
  The institutional ethics committee approved the study, and written informed consent was obtained. Seventy-nine consecutive patients with cirrhosis who were undergoing SWE and TE at the time of HVPG measurement were studied. The technical success rate of SWE and TE was compared with the diagnostic value of liver stiffness (LS) and spleen stiffness (SS) measurements and composite scores (LS spleen-diameter-to-platelet-ratio score [LSPS] and PH risk score) by using SWE and TE to detect clinically significant PH (HVPG ≥ 10 mm Hg) and esophageal varices at high risk of bleeding. Areas under the receiver operating characteristic curve and the DeLong test were used.
  
  
  RESULTS
  The technical success rate of SWE was significantly better than that of TE for both LS and SS (97% and 97% vs 44% and 42%, respectively; P < .001). LS of more than 24.6 kPa with SWE had a sensitivity, specificity, and accuracy for clinically significant PH of 81%, 88%, and 82%, respectively. Diagnostic performance of LS by using SWE was significantly better than that for SS for the diagnosis of clinically significant PH (area under the receiver operating characteristic curve of 0.87 vs 0.64, P = .003). LS, SS, LSPS, and PH risk score (according to SWE or TE) did not differ between patients with and those without high-risk esophageal varices (P = .09-.42).
  
  
  CONCLUSIONS
  In patients with advanced cirrhosis who are undergoing HVPG measurements, LS measurements obtained by using SWE have a higher technical success rate and a better diagnostic value than TE for clinically significant PH.
authors.affiliation: From the Departments of Hepatology (L.E., P.E.R., C.F., A.P., F.D., D.V., D.L., L.C.) and Radiology (M.R., S.L., M.D.B., V.V.), Hôpital Beaujon-AP-HP, Université Paris Diderot, and INSERM U1149, Centre de Recherche sur l'Inflammation, 100 Boulevard du General Leclerc, 92100 Clichy, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Elkrief
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Rautou
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.forename: Simon
authors.initials: S
authors.lastname: Lambert
authors.forename: Marco
authors.initials: M
authors.lastname: Dioguardi Burgio
authors.forename: Claire
authors.initials: C
authors.lastname: Francoz
authors.forename: Aurélie
authors.initials: A
authors.lastname: Plessier
authors.forename: François
authors.initials: F
authors.lastname: Durand
authors.forename: Dominique
authors.initials: D
authors.lastname: Valla
authors.forename: Didier
authors.initials: D
authors.lastname: Lebrec
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Laurent
authors.initials: L
authors.lastname: Castéra
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging*; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013154:Spleen / Q000000981:diagnostic imaging*