Liver stiffness assessed by real-time two-dimensional shear wave elastography predicts hypersplenism in patients with Wilson\u2019s disease: a prospective study

Jiajia Wang,Lanting Sun,Qiang Zhu,Minxia Hu

doi:10.1186/s12880-022-00749-x

Abstract

BackgroundThe current study aimed to explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE) to predict hypersplenism occurrence in Wilson’s disease (WD) patients.MethodsNinety WD patients were enrolled in this prospective study between May 2018 and December 2018. Baseline clinical data and ultrasound imaging including 2D-SWE liver stiffness of WD patients were collected. After enrollment, patients had follow-ups for 24 months or until they developed hypersplenism. The hypersplenism risk factors were determined using Cox regressions and receiver operating characteristic curves (ROC).ResultsTwenty-nine (32.2%) patients developed hypersplenism. Age, portal vein diameter, and liver stiffness were independent hypersplenism risk factors in WD patients. The cutoff value of liver stiffness to predict hypersplenism was 10.45 kPa, with sensitivity and specificity of 75.9% and 73.8%, respectively. Patients were divided into two groups according to liver stiffness: ≥ 10.45 kPa (57.9% with hypersplenism) or < 10.45 kPa (13.5% with hypersplenism). The median time between enrollment and hypersplenism development was 15 months vs. 22 months (p < 0.001) for the two groups, respectively.ConclusionThe measurement of liver stiffness by 2D-SWE can be a reliable hypersplenism predictor in WD patients. Therefore, dynamic monitoring of WD patients using 2D-SWE is crucial for the early diagnosis of hypersplenism.

Highlights

The current study aimed to explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE) to predict hypersplenism occurrence in Wilson’s disease (WD) patients
It has been reported that the assessment of liver stiffness by real-time two-dimensional shear wave elastography (2DSWE) can be applied to predict various hepatic adverse events such as liver cancer caused by hepatitis B and liver failure caused by liver cancer [11, 12], as well as to evaluate whether hepatic patients have complicated portal hypertension [13,14,15]
Clinical data including sex, age, body mass index (BMI), presence of Kayser-Fleischer (K-F) ring, fibrosis index based on four factors (FIB-4), and aminotransferase/platelet count ratio index (APRI) were collected

Summary

Introduction

The current study aimed to explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE) to predict hypersplenism occurrence in Wilson’s disease (WD) patients. It has been reported that the assessment of liver stiffness by real-time two-dimensional shear wave elastography (2DSWE) can be applied to predict various hepatic adverse events such as liver cancer caused by hepatitis B and liver failure caused by liver cancer [11, 12], as well as to evaluate whether hepatic patients have complicated portal hypertension [13,14,15]. The Baveno VI criteria (2015) suggests that transient elastography (TE) can clinically identify significant portal hypertension (CSPH) (1b; A) [16] On this basis, Fofiu R raised 2D-SWE had a good performance to predict high-risk varices (HRV),) including esophageal varices (EV) and gastric varices (GV) in advanced chronic liver disease (cACLD) [17]. No attention has yet been paid to the value of 2D-SWE to predict hypersplenism in WD patients mainly due to the rarity of this disease

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