Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2017; 23(45): 8044-8052
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8044
Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension
Yan Zhang, Da-Feng Mao, Mei-Wu Zhang, Xiao-Xiang Fan
Yan Zhang, Da-Feng Mao, Mei-Wu Zhang, Xiao-Xiang Fan, Department of Interventional Therapy, Second Hospital of Ningbo Municipality, Ningbo 315010, Zhejiang Province, China
Author contributions: Zhang Y, Mao DF, Zhang MW and Fan XX designed the research and analyzed the data; Zhang Y and Fan XX performed the research; Zhang Y, Mao DF and Zhang MW contributed new reagents/analytic tools; Zhang Y wrote the paper.
Supported by Medical and Health Science and Technology Program of Zhejiang Province, 2017, No. 2017KY590.
Institutional review board statement: The study was reviewed and approved by Second Hospital of Ningbo Municipality Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Yan Zhang, Associate Chief Physician, Department of Interventional Therapy, Second Hospital of Ningbo Municipality, No. 52, Yongfeng Road, Haishu District, Ningbo 315010, Zhejiang Province, China. zhangyan@hos_nb.com
Telephone: +86-574-83870763 Fax: +86-574-83870763
Received: June 13, 2017
Peer-review started: June 14, 2017
First decision: July 17, 2017
Revised: August 30, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: December 7, 2017
Processing time: 173 Days and 23.8 Hours
Abstract
AIM

To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension, and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.

METHODS

All 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore, 67 patients were followed-up at 20 mo after treatment, and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1st week, 3rd month and 9th month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group, while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile, in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension, Cox’s proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic (ROC) curves.

RESULTS

The liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline, while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore, liver and spleen shear wave velocity was higher in the unfavorable prognosis group, compared with the favorable prognosis group; the differences were statistically significant (P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3rd month after treatment [relative risk (RR) = 3.481]. At the 9th month after treatment, the prognosis was affected by liver hardness (RR = 5.241) and spleen hardness (RR = 7.829). The differences between these two groups were statistically significant (P < 0.05). The ROC analysis revealed that the area under the curve (AUC) of spleen hardness at the 3rd month after treatment was 0.644, while the AUCs of liver and spleen hardness at the 9th month were 0.579 and 0.776, respectively. These might predict the prognosis of patients with portal hypertension.

CONCLUSION

Spleen hardness at the 3rd month and liver and spleen shear wave velocity at the 9th month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.

Keywords: Liver cirrhosis; Portal hypertension; Liver and spleen shear wave velocity; Acoustic radiation force impulse

Core tip: Sixty-seven patients with liver cirrhosis with portal hypertension were assessed by acoustic radiation force impulse imaging at different time points after treatment. We found that the portal hypertension was significantly affected by spleen hardness at the 3rd month after treatment [relative risk (RR) = 3.481]. At the 9th month after treatment, the prognosis was affected by liver hardness (RR = 5.241) and spleen hardness (RR = 7.829). ROC analysis revealed that the area under the curve of liver and spleen hardness might be used to predict the prognosis of patients with portal hypertension.