Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis

• DOI: 10.1007/s00330-014-3124-y
• Publication Date: 2014-03-13T21:38:04Z
• Authors: Maxime Ronot; Simon Lambert; Laure Elkrief; Sabrina Doblas; Pierre-Emmanuel R...; Laurent Castera; Valérie Vilgrain; Ralph Sinkus; Bernard E. Van Beers; Philippe Garteiser
• Keywords: Adult; Liver Cirrhosis; Male; 610; Esophageal and Gastric Varices; Risk Assessment; Imaging; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Predictive Value of Tests; Hypertension, Portal; 617; [INFO.INFO-IM]Computer Science [cs]/Medical Imaging; Humans; Prospective Studies; Aged; 600; Middle Aged; Magnetic Resonance Imaging; Logistic Models; Liver; ROC Curve; Hypertension; Three-Dimensional; Multivariate Analysis; Elasticity Imaging Techniques; Portal; Female; Spleen

To assess the value of the liver and spleen viscoelastic parameters at multifrequency MR elastography to determine the degree of portal hypertension and presence of high-risk oesophageal varices in patients with cirrhosis.From January to September 2012, 36 consecutive patients with cirrhosis evaluated for transplantation were prospectively included. All patients underwent hepatic venous pressure gradient (HVPG) measurements and endoscopy to assess oesophageal varices. Multifrequency MR elastography was performed within the liver and spleen. The shear, storage and loss moduli were calculated and compared to the HVPG with Spearman coefficients and multiple regressions. Patients with and without severe portal hypertension and high-risk varices were compared with Mann-Whitney tests, logistic regression and ROC analysis.The liver storage and loss moduli and the spleen shear, storage and loss moduli correlated with the HVPG. At multiple regression, only the liver and the spleen loss modulus correlated with the HVPG (r = 0.44, p = 0.017, and r = 0.57, p = 0.002, respectively). The spleen loss modulus was the best parameter for identifying patients with severe portal hypertension (p = 0.019, AUROC = 0.81) or high-risk varices (p = 0.042, AUROC = 0.93).The spleen loss modulus appears to be the best parameter for identifying patients with severe portal hypertension or high-risk varices.1. Noninvasive HVPG assessment can be performed with liver and spleen MR elastography 2. The spleen loss modulus enables the detection of high-risk oesophageal varices 3. The spleen loss modulus enables the detection of severe portal hypertension.