Original Research

Our experience with liver and spleen elastography in the prediction of oesophageal varices

Shivali Arya, Rashmi Dixit, Sneha Harish C, Anjali Prakash, Amarender S. Puri
South African Journal of Radiology | Vol 28, No 1 | a2724 | DOI: https://doi.org/10.4102/sajr.v28i1.2724 | © 2024 Shivali Arya, Rashmi Dixit, Sneha Harish C, Anjali Prakash, Amarender S. Puri | This work is licensed under CC Attribution 4.0
Submitted: 27 May 2023 | Published: 25 January 2024

About the author(s)

Shivali Arya, Department of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi Department of Radiodiagnosis, Government Medical College, Chandigarh, India
Rashmi Dixit, Department of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, India
Sneha Harish C, Department of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, India
Anjali Prakash, Department of Radiodiagnosis, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, India
Amarender S. Puri, Department of Gastroenterology, Govind Ballabh Pant Hospital, New Delhi, India

Abstract

Background: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive.

Objectives: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV.

Method: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups.

Results: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p < 0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p < 0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p < 0.05).

Conclusion: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs.

Contribution: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV.


Keywords

oesophageal varices; acoustic radiation force imaging; chronic liver disease; shear wave velocity; splenic stiffness; hepatic stiffness

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Goal 16: Peace, justice and strong institutions

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