The role of spleen elastometry in the non-invasive assessment of portal hypertension in liver cirrhosis
T. Alaeddinе, Y.M. Ngameni, O.I. Tarasova
Background. Portal hypertension (PH) is one of the leading complications of liver cirrhosis (LC) and determines the risk of developing esophageal varices (EV). Measurement of the hepatic venous pressure gradient is considered a standard indicator of PH; however, this method is invasive and has limited availability. In recent years, spleen elastometry has become a promising non-invasive method for assessing the severity of PH in patients with LC.
Objective: To study the diagnostic value of spleen elastometry in patients with PH associated with LC in the compensation stage and to evaluate the correlation between spleen stiffness (SS) parameters and clinical and instrumental PH features.
Materials and methods. A prospective cross-sectional study included 44 patients (26 male and 18 female individuals) with PH associated with LC and the development of grade 1–2 EVs. All participants underwent liver transient elastography using a FibroScan 502 Touch (Probe M) device and spleen elastometry using a BIOSS ANGIODIN-Sono/P-Ultra ultrasound system. The average age of the participants was 50 (44–60) years. According to the Child–Pugh scale, 26 patients (59.1%) were classified as class A cirrhosis and 18 patients (40.9%) as class B. Esophageal varices (EV) of grade 1 were detected in 20 (45.5%) patients and grade 2 in 24 (54.5%) patients. Spleen size (longitudinal and transverse), liver stiffness (LS) and SS, platelet levels, albumin, international normalized ratio (INR), and EV grade (based on esophagogastroduodenoscopy) were assessed.
Results. In the overall sample, the median SS of the group was 60.5 (IQR 48.0–69.0) kPa, LS – 30.6 (IQR 27.1–48.9) kPa. SS was higher in grade 2 EV than in grade 1 EV: 65.0 (IQR 61.3–69.9) vs. 50.0 (IQR 43.0–62.0) kPa (p = 0.008). The results of determination of SS in patients with LC class A and class B according to Child–Pugh were statistically insignificant (p = 0.48). Correlation analysis revealed a moderate correlation between spleen stiffness and platelet count (ρ = -0.46; p = 0.002), as well as an association with spleen length (ρ = 0.41; p = 0.006), spleen structure (ρ = 0.44; p = 0.003), and the grade of EV (ρ = 0.39; p = 0.009). Correlation between SS and LS, albumin, INR, and Child–Pugh LC class was weak and non-significant. ROC analysis for predicting grade 2 EV using SS parameters yielded the following results: area under the curve (AUC) = 0.74, cutoff value – 58 kPa (sensitivity 75%, specificity 70%).
Conclusion. SS was significantly higher in patients with grade 2 EV comparatively to grade 1 EV, while its association with Child–Pugh cirrhosis class was not found. A spleen stiffness cutoff of 58 kPa allows for a moderate differentiation (AUC = 0.74) of grade 2 EV, which can be used for risk stratification and endoscopic screening planning. Compared with LS measurements, spleen elastometry data better reflects portal hypertension severity, making this method a potential additional noninvasive tool in the management of patients with LC.
For citation: Alaeddine T, Ngameni YM, Tarasova OI. The role of spleen elastometry in the non-invasive assessment of portal hypertension in liver cirrhosis. Therapy (Moscow). 2026;12(5S):44–50.
https://dx.doi.org/10.18565/therapy.2026.5-s5.44-50
Ключевые слова
liver cirrhosis
portal hypertension
spleen elastometry
elastography
spleen stiffness
ultrasound
esophageal varices
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Об авторах / Для корреспонденции
Tarek Alaeddine, MD, postgraduate student of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical institute, RUDN University, Moscow, Russian Federation, Lebanese RepublicE-mail: tarek.m.a@outlook.com
ORCID: https://orcid.org/0009-0001-7144-5918
Yannick M. Ngameni, MD, gastroenterologist-hepatologist at the Center for Liver Research named after professor P.P. Ogurtsov of the Clinical and diagnostic center, RUDN University, Moscow, Russian Federation, Republic of Cameroon
E-mail: yannickmoy43267@gmail.com
ORCID: https://orcid.org/0000-0001-7230-3711
Olga I. Tarasova, MD, PhD (Medicine), associate professor, associate professor of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics, RUDN University, Moscow, Russian Federation.
E-mail: tarasova-oi@rudn.ru
ORCID: https://orcid.org/0000-0001-6376-8189. Scopus ID: 56362675300. eLibrary SPIN: 7367-7415
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