Role of spleen elastography in patients with chronic liver diseases.
The development of liver cirrhosis and portal hypertension (PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases (CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure gradient is the standard to ascertain the presence of PH and upper endoscopy is the method of choice to detect the presence of oesophageal varices. However, several non-invasive tests, including elastographic techniques, are currently used to evaluate the severity of liver disease and predict its prognosis. More recently, the measurement of the spleen stiffness has become particularly attractive to assess, considering the relevant role accomplished by the spleen in splanchnic circulation in the course of liver cirrhosis and in the PH. Moreover, spleen stiffness as compared with liver stiffness better represents the dynamic changes occurring in the advanced stages of cirrhosis and shows higher diagnostic performance in detecting esophageal varices. The aim of this review is to provide an exhaustive overview of the actual role of spleen stiffness measurement as assessed by several elastographic techniques in evaluating both liver disease severity and the development of cirrhosis complications, such as PH and to highlight its potential and possible limitations.
Mariangela Giunta, Dario Conte, Mirella Fraquelli, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Mariangela
M
Giunta
Mariangela Giunta, Dario Conte, Mirella Fraquelli, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Dario
D
Conte
Mariangela Giunta, Dario Conte, Mirella Fraquelli, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Mirella
M
Fraquelli
D000818:Animals; D001201:Ascites / Q000473:pathology; D001706:Biopsy / Q000009:adverse effects; D002908:Chronic Disease; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications; D005355:Fibrosis / Q000503:physiopathology; D006471:Gastrointestinal Hemorrhage / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis; D008107:Liver Diseases / Q000175:diagnosis / Q000473:pathology*; D011237:Predictive Value of Tests; D011312:Pressure; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013154:Spleen / Q000473:pathology*
Cirrhosis; Elastography; Portal hypertension; Spleen stiffness; Transient elastography
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