Abstract
Introduction
In patients with portal hypertension (PH), the differential diagnosis between porto-sinusoidal
vascular disease (PSVD) and cirrhosis is challenging. This study aims to evaluate
the diagnostic accuracy of the SSM/LSM index in the diagnosis of PSVD.
Methods
Prospective study of patients with PH and PSVD or cirrhosis. Transient liver and spleen
elastography were performed and the ratio between spleen stiffness measurement (SSM)
and liver stiffness measurement (LSM) was calculated. The relation of SSM/LSM with
the diagnosis of PSVD was evaluated.
Results
Forty-four patients with PSVD and 44 patients with cirrhosis were evaluated. Median
age was 57.5 (IQR 49.0–64.5) years, 66.3% were males. In patients with PSVD, median
SSM was 59.4 (33.5–77.7) kPa, median LSM was 6.2 (5.2–10.2) kPa and median SSM/LSM
was 5.62 (3.15–9.68). In patients with cirrhosis, median SSM was 47.3 (24.3–60.3)
kPa, median LSM was 27.8 (17.7–53.9) kPa and median SSM/LSM was 1.55 (1.06–3.24).
The SSM/LSM AUROC was 0.940 (p<0.001). Using 2 as a cut-off, we obtained good sensitivity (86.5%), specificity (92.7%),
and accuracy (89.7%) for the diagnosis of PSVD.
Conclusion
The SSM/LSM index is useful in the differential diagnosis between liver cirrhosis
and PSVD. Using the cut-off of 2 we achieved a good sensitivity and specificity for
diagnosing PSVD.
Keywords
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Article Info
Publication History
Published online: October 21, 2022
Accepted:
September 30,
2022
Received:
July 12,
2022
Publication stage
In Press Corrected ProofFootnotes
Financial disclosure: None to report.
Conflicts of interest from all authors: None to report.
Financial relationships relevant to this publication: None to report.
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
