Correlation Of Liver And Spleen Stiffness Measured By Acoustic Radiation Force Impulse With Hepatic Venous Pressure Gradient

Objective:To investigate the correlation of liver and spleen stiffness measured by acoustic radiation force impulse(ARFI) with HVPG, and to evaluate the value of liver stiffness(LS) and spleen stiffness(SS) in the diagnosis of portal hypertension.Methods:20 cases of liver cirrhosis with portal hypertension who received HVPG measurement in Nanjing Drum Tower Hospital from April 2014 to March 2016 were included in the research.Before HVPG measurement, LS and SS were assessed in all patients together with laboratory tests.We analyzed the correlation of HVPG and age,alanine aminotransferase,aspartate aminotransferase,platelet count.prothrombin time,aspartate aminotransferase to platelet ratio index(APRI),Chid score,MELD score,LS,SS.Results:HVPG,LS and SS were successfully measured in all patients.Age,ALT,AST,total bilirubin, albumin, platelet count,prothrombin time,APRI,Child-Pugh score,MELD score.were not significantly correlated with HVPG.But HVPG was found to be positively correlated with LS and SS(P<0.05).The predictive equation of HVPG was HVPG=-20.871+10.66*LS+5.32*SS.To predict HVPG>12mmHg,the AUROC of LS and SS were 0.875 and 0.711 respectively.The optimal cut off value of LS was 1.77m/s(scnsitivity 68.8%,specificity 100%)while the cut off value of SS was 3.18m/s(sensitivity 68.8%,specificity 75%).To predict HVPG>20mmHg,the AUROC of LS and SS were 0.798 and 0.820.The optimal cut off value of LS was 1.85m/s with a sensitivity of 68.6%,a specificity of 100%.The optimal cut off value of SS was 3.23m/s with a sensitivity of 100%,a specificity of 56.2%.Conclusion:Liver stiffness and spleen stiffness assessed by ARFI are correlated with HVPG in liver cirrhosis patients and therefore are valuable in diagnosing portal hypertension.