The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD)
The progression of liver fibrosis and the presence of portal hypertension are two key points in the follow-up and severity assessment of patients with chronic liver disease. Objective evaluation of such aspects has proven to be difficult due to the lack of reproducible and standardized non-invasive...
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MDPI AG
2023-05-01
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| Online Access: | https://www.mdpi.com/2076-3417/13/9/5764 |
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| author | Vasile-Andrei Olteanu Catalin-Victor Sfarti Gheorghe G. Balan Oana Timofte Elena Gologan Dana Elena Mitrică Georgiana-Emmanuela Gilca-Blanariu Cristina Gena Dascalu Ion Sandu Gabriela Ştefănescu |
| author_facet | Vasile-Andrei Olteanu Catalin-Victor Sfarti Gheorghe G. Balan Oana Timofte Elena Gologan Dana Elena Mitrică Georgiana-Emmanuela Gilca-Blanariu Cristina Gena Dascalu Ion Sandu Gabriela Ştefănescu |
| author_sort | Vasile-Andrei Olteanu |
| collection | DOAJ |
| description | The progression of liver fibrosis and the presence of portal hypertension are two key points in the follow-up and severity assessment of patients with chronic liver disease. Objective evaluation of such aspects has proven to be difficult due to the lack of reproducible and standardized non-invasive methods. Therefore, the aim of this study was to evaluate whether spleen stiffness (SS) can rule out the presence of high-risk varices (HRVs) in patients with non-alcoholic fatty liver disease (NAFLD). We designed a prospective follow-up of a cohort of 48 consecutive patients diagnosed with compensated advanced chronic liver disease (cACLD) due to NAFLD, between January 2020 and January 2021. After clinical evaluation, laboratory testing, ultrasonography (US), and shear-wave elastography (2D-SWE.GE) of both the liver and the spleen, patients were endoscopically screened for esophageal varices, gastric varices, and portal hypertensive gastropathy. Correlations and predictors were assessed. After univariate, multivariate, and predictive analyses, SS could be referred to as an independent predictor for high-risk varices (AUROC 0.987, <i>p</i> < 0.001, OR 4.985, 95% CI: 1.57–15.73, <i>p</i> = 0.006), with a calculated cutoff value of 17.95 kPa. These results are consistent with those of other, similar studies using both 2D-SWE.GE and a similar module (2D-SWE.SSI) in patients with metabolic liver disease. When confirmed by subsequent larger studies, SS could potentially become a useful non-invasive tool in the assessment of clinically significant portal hypertension in patients with advanced fatty liver disease. |
| first_indexed | 2024-03-11T04:22:51Z |
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| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-11T04:22:51Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
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| spelling | doaj.art-0a6d368c3d3a4740a0637d3c6a0387c52023-11-17T22:38:28ZengMDPI AGApplied Sciences2076-34172023-05-01139576410.3390/app13095764The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD)Vasile-Andrei Olteanu0Catalin-Victor Sfarti1Gheorghe G. Balan2Oana Timofte3Elena Gologan4Dana Elena Mitrică5Georgiana-Emmanuela Gilca-Blanariu6Cristina Gena Dascalu7Ion Sandu8Gabriela Ştefănescu9Gastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Medical Informatics, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaAcademy of Romanian Scientists (AORS), 54 Splaiul Independentei St., Sector 5, 050094 Bucharest, RomaniaGastroenterology Department, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaThe progression of liver fibrosis and the presence of portal hypertension are two key points in the follow-up and severity assessment of patients with chronic liver disease. Objective evaluation of such aspects has proven to be difficult due to the lack of reproducible and standardized non-invasive methods. Therefore, the aim of this study was to evaluate whether spleen stiffness (SS) can rule out the presence of high-risk varices (HRVs) in patients with non-alcoholic fatty liver disease (NAFLD). We designed a prospective follow-up of a cohort of 48 consecutive patients diagnosed with compensated advanced chronic liver disease (cACLD) due to NAFLD, between January 2020 and January 2021. After clinical evaluation, laboratory testing, ultrasonography (US), and shear-wave elastography (2D-SWE.GE) of both the liver and the spleen, patients were endoscopically screened for esophageal varices, gastric varices, and portal hypertensive gastropathy. Correlations and predictors were assessed. After univariate, multivariate, and predictive analyses, SS could be referred to as an independent predictor for high-risk varices (AUROC 0.987, <i>p</i> < 0.001, OR 4.985, 95% CI: 1.57–15.73, <i>p</i> = 0.006), with a calculated cutoff value of 17.95 kPa. These results are consistent with those of other, similar studies using both 2D-SWE.GE and a similar module (2D-SWE.SSI) in patients with metabolic liver disease. When confirmed by subsequent larger studies, SS could potentially become a useful non-invasive tool in the assessment of clinically significant portal hypertension in patients with advanced fatty liver disease.https://www.mdpi.com/2076-3417/13/9/5764esophageal varicesspleen stiffnessvariceal bleedingcompensated advanced chronic liver disease |
| spellingShingle | Vasile-Andrei Olteanu Catalin-Victor Sfarti Gheorghe G. Balan Oana Timofte Elena Gologan Dana Elena Mitrică Georgiana-Emmanuela Gilca-Blanariu Cristina Gena Dascalu Ion Sandu Gabriela Ştefănescu The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) Applied Sciences esophageal varices spleen stiffness variceal bleeding compensated advanced chronic liver disease |
| title | The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) |
| title_full | The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) |
| title_fullStr | The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) |
| title_full_unstemmed | The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) |
| title_short | The Role of Shear-Wave Elastography of the Spleen in Ruling out the Presence of High-Risk Varices in Non-Alcoholic Fatty Liver Disease (NAFLD) |
| title_sort | role of shear wave elastography of the spleen in ruling out the presence of high risk varices in non alcoholic fatty liver disease nafld |
| topic | esophageal varices spleen stiffness variceal bleeding compensated advanced chronic liver disease |
| url | https://www.mdpi.com/2076-3417/13/9/5764 |
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