Non-invasive splenic parameters of portal hypertension:Assessment and utility

作     者：Ayesha Karim Ahmad Sebastiana Atzori James Maurice Simon D Taylor-Robinson Adrian KP Lim 

作者机构：Liver UnitDepartment of DigestionMetabolism&ReproductionFaculty of MedicineImperial College LondonLondon W21NYUnited Kingdom Liver UnitDepartment of DigestionMetabolism&ReproductionImperial College LondonLondon W21NYUnited Kingdom Liver Unit and ImagingDepartment of DigestionMetabolism&ReproductionImperial College LondonLondon W21NYUnited Kingdom 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第11期

页      面：1055-1066页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Philips 

主　　题：Portal hypertension Esophageal varices Point shear wave elastography Spleen stiffness Spleen area Non-invasive 

摘      要：BACKGROUND Portal hypertension is a major complication of cirrhosis that is associated with significant morbidity and *** present gold-standard method to risk stratify and observe cirrhosis patients with portal hypertension is hepatic venous pressure gradient measurement or ***,these methods are invasive,carry a risk of complications and are associated with significant patient ***,non-invasive splenic parameters are of clinical interest as potential useful markers in determining the presence of portal ***,diagnostic accuracy and reproducibility remains *** To assess the diagnostic accuracy of spleen stiffness,area and diameter in predicting the presence of portal *** Of 50 patients with varying liver disease pathologies were prospectively recruited from the ***’s Hospital Liver Unit in London;25 with evidence of portal hypertension and 25 with no evidence of portal *** stiffness,spleen stiffness,spleen diameter and spleen area were measured using the Philips Affiniti 70 elastography point quantification point shear wave elastography *** aspartate aminotransferase-to-platelet-ratio-index(APRI)score was also *** measures,univariate and multivariate logistic regression were used to evaluate demographic,clinical and elastography *** correlation coefficient was used to determine the reproducibility of splenic area and *** On univariate and individual performance,platelet count[area under the receiver operating characteristic(AUROC)0.846,P value0.001],spleen area(AUROC 0.828,P value=0.002)and APRI score(AUROC 0.827,P value0.001)were the most accurate variables in identifying the presence of portal *** multivariate logistic regression models constructed,the combination of spleen area greater than 57.90 cm2 and platelet count less than 126×10^9 had 63.2%sensitivity and 100%specificity