Department of Hematology, Faculty of Medicine, Firat University, Elaziğ, Turkey.
Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
Ultrasound Q. 2021 Jun 1;37(2):149-154. doi: 10.1097/RUQ.0000000000000486.
Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases that can transform to secondary myelofibrosis (SMF). In this study, we evaluated spleen stiffness using shear-wave elastography (SWE) as a predictor of progression to SMF.
Participants were grouped as healthy volunteers (HVs), PV/ET patients, and SMF patients. Participants' spleen sizes, spleen stiffness values, bone marrow fibrosis degrees, and the other parameters were evaluated. Spleen stiffness values and spleen sizes were compared between groups.
Of the 121 participants included in this study, 52 patients were HVs, 52 patients were PV and/or ET patients, and 17 patients were SMF patients. In terms of age and sex, there was no difference between groups. Splenic parenchymal stiffness median values by using SWE were found to be 0.82 m/s in HVs, 1.41 m/s in PV/ET patients, and 2.32 m/s in SMF patients (P < 0.001). In terms of median length of the spleen, the difference between groups was significant (P < 0.001). In addition, we found a significant positive correlation between spleen stiffness and bone marrow fibrosis degree (P < 0.001, r = 0.757). However, in multivariate analysis, there was no strong independent risk factor for spleen stiffness.
In this study, we showed that measurement of spleen stiffness using SWE can distinguish SMF from PV/ET patients and HVs. Therefore, we believe that SWE may be used as a noninvasive and easily accessible method to check the fibrotic progression of bone marrow in PV and ET patients to monitor the transformation to SMF, and enables to detect fibrosis in early phase.
真性红细胞增多症（PV）和特发性血小板增多症（ET）是慢性骨髓增殖性疾病，可转化为继发性骨髓纤维化（SMF）。本研究评估了剪切波弹性成像（SWE）作为预测向 SMF 进展的指标。
将参与者分为健康志愿者（HV）、PV/ET 患者和 SMF 患者三组。评估了参与者的脾脏大小、脾脏硬度值、骨髓纤维化程度和其他参数。比较了各组的脾脏硬度值和脾脏大小。
本研究共纳入 121 名参与者，其中 52 名 HV、52 名 PV/ET 患者和 17 名 SMF 患者。三组在年龄和性别方面无差异。使用 SWE 测量的脾脏实质硬度中位数在 HV 中为 0.82 m/s，在 PV/ET 患者中为 1.41 m/s，在 SMF 患者中为 2.32 m/s（P < 0.001）。脾脏长度中位数在组间差异有统计学意义（P < 0.001）。此外，我们发现脾脏硬度与骨髓纤维化程度呈显著正相关（P < 0.001，r = 0.757）。然而，在多变量分析中，脾脏硬度没有强的独立危险因素。
在本研究中，我们表明使用 SWE 测量脾脏硬度可以区分 SMF 与 PV/ET 患者和 HV。因此，我们认为 SWE 可能作为一种非侵入性且易于获得的方法，用于检查 PV 和 ET 患者骨髓纤维化的进展，以监测向 SMF 的转化，并能够检测早期纤维化。
