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Splenic-hepatic elastography index is useful in differentiating between porto-sinusoidal vascular disease and cirrhosis in patients with portal hypertension

  • Joel Ferreira-Silva
    Correspondence
    Corresponding author at: Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal.
    Affiliations
    Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal

    Faculty of Medicine of the University of Porto, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal
    Search for articles by this author
  • Rui Gaspar
    Affiliations
    Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal

    Faculty of Medicine of the University of Porto, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal
    Search for articles by this author
  • Rodrigo Liberal
    Affiliations
    Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal

    Faculty of Medicine of the University of Porto, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal
    Search for articles by this author
  • Hélder Cardoso
    Affiliations
    Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal

    Faculty of Medicine of the University of Porto, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal
    Search for articles by this author
  • Guilherme Macedo
    Affiliations
    Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal

    Faculty of Medicine of the University of Porto, Porto, Portugal. Alameda Prof. Hernâni Monteiro 4200 - 319 Porto, Portugal
    Search for articles by this author
Published:October 21, 2022DOI:https://doi.org/10.1016/j.dld.2022.09.018

      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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