Clinical applications of spleen ultrasound elastography – a review

• Authors: Rafał Mazur , Milena Celmer , Jurand Silicki , Daniel Hołownia , Patryk Pozowski , Krzysztof Międzybrodzki

Title variants

PL

Kliniczne zastosowania sonoelastografii śledziony – przegląd

• Languages of publication: EN

Abstracts

EN

In the last few years, notable technical progress has taken place in ultrasound elastography. Qualitative methods have been replaced by quantitative ones, such as: transient elastography, acoustic radiation force impulse and shear wave elastography. Owing to the fact that the spleen is superficially located, it is possible to obtain reliable measuring accuracy of its hardness using sonoelastography. Lately, many researchers have been investigating how spleen elasticity changes in patients infected with hepatitis B virus or hepatitis C virus and in patients suffering from liver fibrosis, portal hypertension, esophageal varices or myelofibrosis. In this article, we review the role and current status of accessible qualitative ultrasound elastography methods, including recent advances in the evaluation of spleen stiffness and its clinical utility. As study results demonstrate, spleen stiffness correlates with liver fibrosis and is helpful in determining the level of fibrosis in the METAVIR scoring system. In patients infected with hepatitis B virus or hepatitis C virus, spleen stiffness increases even when liver elasticity remains unaltered. Furthermore, it is useful in diagnosing portal hypertension or predicting existence of esophageal varices. Moreover, in patients suffering from biliary atresia after Kasai portoenterostomy, spleen sonoelastography may be helpful in selecting patients for liver transplantation as well as for choosing the best strategy for portal vein reconstruction before liver transplantation. In myelofibrosis, spleen stiffness correlates with bone marrow fibrosis and may be used to assess the response to treatment. Spleen sonoelastography is also useful in the monitoring of transjugular intrahepatic portosystemic shunt function.

PL

Od kilku lat zauważalny jest postęp w sonoelastografii. Metody ilościowe zostały zastąpione przez jakościowe, takie jak: elastografia dynamiczna impulsowa, elastografia impulsu mocy promieniowania akustycznego i elastografia fali poprzecznej. Powierzchowne położenie śledziony umożliwia uzyskanie za pomocą sonoelastografii wiarygodnych, dokładnych pomiarów twardości tego narządu. W ostatnim czasie przeprowadzono wiele badań dotyczących elastyczności śledziony u pacjentów z wirusowym zapaleniem wątroby typu B lub C, cierpiących na zwłóknienie wątroby, nadciśnienie wrotne, żylaki przełyku lub mielofibrozę. W niniejszym artykule dokonano przeglądu roli i aktualnego statusu dostępnych jakościowych metod sonoelastografii, uwzględniając ostatnie postępy w ocenie twardości śledziony i jej klinicznego zastosowania. Jak pokazują wyniki badań, twardość śledziony koreluje ze zwłóknieniem wątroby i jest pomocna w określaniu stopnia zwłóknienia wątroby w skali METAVIR. U pacjentów zakażonych wirusem wątroby typy B lub C twardość śledziony wzrasta, nawet jeśli twardość wątroby pozostaje niezmieniona. Co więcej, jest użyteczna w diagnostyce nadciśnienia wrotnego i przewidywaniu obecności żylaków przełyku. Ponadto, u pacjentów cierpiących na zarośnięcie dróg żółciowych leczonych portoenterostomią sposobem Kasai elastografia śledziony może być użyteczna podczas selekcji pacjentów do przeszczepu wątroby oraz do wyboru optymalnej strategii rekonstrukcji żyły wrotnej przed transplantacją wątroby. W mielofibrozie twardość śledziony koreluje z włóknieniem szpiku kostnego i może być użyteczna w ocenie odpowiedzi na leczenie. Sonoelastografia śledziony jest również użyteczna w monitorowaniu funkcjonowania przezszyjnego wewnątrzwątrobowego zespolenia układowo-wrotnego. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-72

Keywords

EN

esophageal varices; liver fibrosis; myelofibrosis; portal hypertension; spleensonoelastography

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Journal of Ultrasonography
• Year: 2018
• Volume: 18
• Issue: 72
• Pages: 37–41

Contributors

author

Rafał Mazur

• Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland; Department of Radiology, Wrocław Medical University, Wroclaw, Poland

author

Milena Celmer

• Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland; Department of Radiology, Wrocław Medical University, Wroclaw, Poland

author

Jurand Silicki

• Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland; Department of Radiology, Wrocław Medical University, Wroclaw, Poland

author

Daniel Hołownia

• Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland

author

Patryk Pozowski

• Faculty of Medicine, Wrocław Medical University, Wrocław, Poland

author

Krzysztof Międzybrodzki

• Department of General and Pediatric Radiology, University Teaching Hospital, Wrocław, Poland; Department of Radiology, Wrocław Medical University, Wroclaw, Poland

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• Document Type: article