Z Gastroenterol 2016; 54 - KV260
DOI: 10.1055/s-0036-1587036

The change of liver and spleen stiffness measured by Shear-wave Elastography after transjugular intrahepatic portosystemic shunt predicts outcome

C Jansen 1, P Möller 1, C Bogs 1, M Praktiknjo 1, J Lehmann 1, D Thomas 2, C Meyer 2, J Chang 1, C Strassburg 1, J Trebicka 1
  • 1Medizinische Klinik I Bonn, Bonn, Deutschland
  • 2Department of Radiology, University of Bonn, Bonn, Deutschland

Background: Shear-wave elastography (SWE) of the liver might be a promising tool to predict portal hypertension. The aim of our prospective study was to investigate the role of liver and spleen SWE and its evolution in patients receiving a transjugular intrahepatic portosystemic shunt (TIPS) insertion.

Methods: We included 73 patients receiving TIPS for prevention of rebleeding and/or therapy-refractory ascites. Hemodynamic parameters were assessed before TIPS and after TIPS insertion. SWE of liver and spleen, as well as clinical and biochemical parameters were assessed before TIPS, seven days and 6 weeks after TIPS.

Results: Liver SWE (L-SWE) and spleen SWE (S-SWE) decreased after TIPS. However, in subgroup analysis one third showed an increase in L-SWE before and seven days after TIPS. The increase in L-SWE was identified as independent predictor of survival. While L-SWE difference showed no significant correlation, S-SWE difference correlated significantly with change of portal pressure and pressure gradient.

Conclusions: In conclusion, this study demonstrates for the first time that change in L-SWE might also be of therapeutic value in patient with liver cirrhosis receiving TIPS. By contrast S-SWE change might be suitable as TIPS follow-up parameter.