Changes in liver stiffness on real-time tissue elastography before and after occlusion of spontaneous portosystemic shunts.
OBJECTIVE
This study was conducted to evaluate changes in liver stiffness, volume, and function before and after occlusion of spontaneous portosystemic shunt.


METHODS
Twenty-four patients (13 men and 11 women) with a mean age of 68.2 years±10.1 (SD) (age range, 49-82 years) underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n=17) or hepatic encephalopathy (n=7) from March 2011 to June 2013. The liver fibrosis index indicating liver stiffness was calculated by using ultrasound elastography before and after shunt occlusion. Liver volume and liver profile were also evaluated.


RESULTS
Spontaneous portosystemic shunt occlusion was uneventfully performed in all patients. The mean liver fibrosis index was significantly decreased from 2.7±1.0 before shunt occlusion to 2.0±0.9 (P<0.001) at 1 month, 2.2±1.0 at 3 months (P=0.004), and 1.6±0.7 at 6 months (P=0.001) afterwards. A significant increase in the liver volume was observed from 1035.3±340.1mL before shunt occlusion to 1116.8±298.4mL (P=0.006) at 1 month and 1174.2±354.1mL (P<0.001) at 3 months afterwards. Significant improvement in the Child-Pugh score was also found at 1 month (6.2±1.4, P<0.001), 3 months (6.5±1.1, P=0.022), and 6 months (6.0±0.9, P=0.004) after shunt occlusion as compared with that (7.2±1.9) before.


CONCLUSIONS
The liver stiffness decreases along with an increase in liver volume and improvement in liver function after spontaneous portosystemic shunt occlusion.
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: k-koba@hyo-med.ac.jp.
K
K
Kobayashi
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: hirota-s@hyo-med.ac.jp.
S
S
Hirota
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: y-kako@hyo-med.ac.jp.
Y
Y
Kako
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: yamabeesat@gmail.com.
S
S
Yamamoto
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: h-taka@hyo-med.ac.jp.
H
H
Takaki
Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501 Nishinomiya, Hyogo, Japan. Electronic address: ko-yamakado@hyo-med.ac.jp.
K
K
Yamakado
D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use; D009929:Organ Size / Q000502:physiology; D011170:Portasystemic Shunt, Surgical; D011379:Prognosis; D012189:Retrospective Studies
D009829:Oleic Acids; C033343:ethanolamine oleate
Elastography; Liver cirrhosis; Liver fibrosis; Portal hypertension; Portosystemic shunt