Department of Ultrasonic Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China 710032.
Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China 710032.
Biomed Res Int. 2021 Apr 17;2021:5530004. doi: 10.1155/2021/5530004. eCollection 2021.
To investigate the performance of spleen stiffness (SS) by using two-dimensional shear-wave elastography (2D-SWE) for assessing the severity of gastroesophageal varices (GEVs) after transjugular intrahepatic portosystemic shunt (TIPS).
102 eligible patients were categorized as in the post-TIPS short-term ( = 69) and long-term ( = 38) follow-up groups. The performance of SS by using 2D-SWE for evaluating the severity of GEVs was compared with liver stiffness (LS), spleen stiffness-to-liver stiffness ratio (SS/LS), liver stiffness spleen-diameter-to-platelet-ratio score (LSPS), portal hypertension (PH) risk score, platelet count-to-spleen diameter ratio (PSR), and varices risk score by using receiver operating characteristic (ROC) curve and DeLong test.
In the post-TIPS short-term follow-up group, area under the receiver operating characteristic curves (AUCs) of SS were 0.585 for mild (cutoff value = 30.3 kPa), 0.655 for moderate (cutoff value = 30.6 kPa), and 0.739 for severe (cutoff value = 31.9 kPa) GEVs, which were higher than other parameters for severe GEVs. AUCs of SS were lower than other parameters for mild and moderate GEVs, but no difference was found ( > 0.05). In the post-TIPS long-term follow-up group, AUCs of SS were 0.778 for mild (cutoff value = 28.9 kPa), 0.82 for moderate (cutoff value = 29.9 kPa), and 0.824 for severe (cutoff value = 37.7 kPa) GEVs, which were higher than other parameters except for severe GEVs. AUC of SS was lower than other parameters for severe GEVs, but no significant difference was found ( > 0.05).
SS is an effective noninvasive tool to predict GEV severity during the post-TIPS follow-up.
使用二维剪切波弹性成像（2D-SWE）评估经颈静脉肝内门体分流术（TIPS）后胃食管静脉曲张（GEV）的严重程度，探讨脾脏硬度（SS）的性能。
102 例符合条件的患者分为 TIPS 后短期（n=69）和长期（n=38）随访组。比较 2D-SWE 评估 GEV 严重程度的 SS 与肝硬度（LS）、脾脏硬度与肝硬度比值（SS/LS）、肝硬度脾脏直径与血小板比值评分（LSPS）、门静脉高压（PH）风险评分、血小板计数与脾脏直径比值（PSR）和静脉曲张风险评分的性能，采用受试者工作特征（ROC）曲线和 DeLong 检验。
在 TIPS 后短期随访组中，SS 的 ROC 曲线下面积（AUC）分别为轻度（截断值=30.3 kPa）、中度（截断值=30.6 kPa）和重度（截断值=31.9 kPa）的 0.585、0.655 和 0.739，对于重度 GEVs，这些值均高于其他参数。对于轻度和中度 GEVs，SS 的 AUC 低于其他参数，但差异无统计学意义（>0.05）。在 TIPS 后长期随访组中，SS 的 AUC 分别为轻度（截断值=28.9 kPa）、中度（截断值=29.9 kPa）和重度（截断值=37.7 kPa）的 0.778、0.82 和 0.824，对于重度 GEVs，这些值均高于其他参数，除了重度 GEVs。对于重度 GEVs，SS 的 AUC 低于其他参数，但差异无统计学意义（>0.05）。
SS 是 TIPS 后随访中预测 GEV 严重程度的一种有效无创工具。
