Dipartimento Universitario Clinico Di Scienze Mediche Chirurgiche e Della Salute, Università Degli Studi Di Trieste, Italy.
Dipartimento Universitario Clinico Di Scienze Mediche Chirurgiche e Della Salute, Università Degli Studi Di Trieste, Italy.
Ann Hepatol. 2019 Sep-Oct;18(5):736-741. doi: 10.1016/j.aohep.2019.03.004. Epub 2019 Apr 25.
This study aims to measure the values of spleen stiffness (SS) in healthy subjects, the inter-operator agreement in SS measurement, and to detect statistically significant correlations between SS and age, sex, weight, BMI, portal vein dynamics and splenic dimensions.
The study included 100 healthy volunteers who had no substantial alcohol intake (<30g/daily for man, <20g/daily women), were negative on hepatitis B, hepatitis C, HIV blood serology, and had any history of lymphoproliferative disorders. Abdominal ultrasound, liver and spleen elastography were performed on each patient to search for focal splenic lesions, bile tract or portal vein dilatation, moderate/severe liver steatosis, and to measure liver and spleen stiffness.
The mean value was 18.14 (±3.08) kPa. In the group of men (n=49), the mean was 17.73 (±2.91) kPa, whereas in the group of women (n=51) it was 16.72 (±3.32) kPa. Statistical analyses showed no correlation between spleen stiffness and sex, age, weight, and BMI. Regarding their splenoportal axis, statistically significant differences in SS were found in the means of the two subgroups of subjects stratified by their portal flow velocity (p=0.003) and spleen area (p<0.001). Spearman's rank showed a weak association between SS and portal flow velocty (r=0.271) and splenic area (r=-0.237). ICC showed excellent (0.96) inter-operator agreement and Bland-Altman plot demonstrated no systematic over/under-estimation of spleen stiffness values.
Our results may serve as a reference point in the evaluation of SS especially in patients affected by advanced liver disease.
本研究旨在测量健康受试者的脾脏硬度（SS）值、SS 测量的操作者间一致性，并检测 SS 与年龄、性别、体重、BMI、门静脉动力学和脾脏大小之间的统计学显著相关性。
该研究纳入了 100 名健康志愿者，他们没有大量饮酒（男性<30g/天，女性<20g/天），乙型肝炎、丙型肝炎、HIV 血清学检测均为阴性，且无淋巴增生性疾病史。对每位患者进行腹部超声、肝脏和脾脏弹性成像，以寻找局灶性脾脏病变、胆管或门静脉扩张、中重度肝脏脂肪变性，并测量肝脏和脾脏硬度。
平均 SS 值为 18.14（±3.08）kPa。在男性组（n=49）中，平均 SS 值为 17.73（±2.91）kPa，而在女性组（n=51）中为 16.72（±3.32）kPa。统计学分析显示，SS 与性别、年龄、体重和 BMI 之间无相关性。关于他们的脾门静脉轴，根据门静脉流速（p=0.003）和脾脏面积（p<0.001）分层的两个亚组的受试者的 SS 均值存在统计学差异。Spearman 秩相关分析显示，SS 与门静脉流速（r=0.271）和脾脏面积（r=-0.237）呈弱相关。ICC 显示了出色的操作者间一致性（0.96），Bland-Altman 图显示 SS 值没有系统的高估或低估。
我们的结果可作为评估 SS 的参考点，特别是在患有晚期肝病的患者中。
