Z Gastroenterol 2016; 54(12): 1343-1404
DOI: 10.1055/s-0036-1597380
2. Clinical Hepatology
Georg Thieme Verlag KG Stuttgart · New York

Shear wave elastography of the liver and spleen in patients with autoimmune hepatitis and its variants – A single centre study

MK Janik
1   Medical University of Warsaw, Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Warsaw, Poland
,
M Krawczyk
2   Saarland University, Department of Medicine II, Saarland University Medical Center, Homburg, Germany
,
B Kruk
3   Medical University of Warsaw, Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Warsaw, Poland
,
K Kostrzewa
1   Medical University of Warsaw, Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Warsaw, Poland
,
J Raszeja-Wyszomirska
1   Medical University of Warsaw, Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Warsaw, Poland
,
F Lammert
2   Saarland University, Department of Medicine II, Saarland University Medical Center, Homburg, Germany
,
P Milkiewicz
1   Medical University of Warsaw, Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Warsaw, Poland
› Author Affiliations
Further Information

Publication History

Publication Date:
19 December 2016 (online)

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Background: Autoimmune hepatitis (AIH) is a chronic liver disease which might lead to advanced fibrosis and cirrhosis. Unlike in viral etiology, data on elastographic assessment of liver fibrosis in AIH is scant and virtually do not exists in terms of spleen elastography. The aim of this study is to evaluate the potential association between shear wave elastography (SWE) of the liver and spleen with various parameters including serum fibrosis markers in patients with autoimmune hepatitis (AIH) and AIH variants.

Materials and Methods: Fifty consecutive in and out-patients (M/F (16/34, mean age: 37yrs.) with AIH and its PSC and PBC variants defined according to recent EASL Clinical Practice Guidelines (J Hepatol 2015) were included. They underwent liver and spleen SWE (SuperSonic Imagine Aixplorer®). Different biochemical tests were performed including fibrosis markers and non-invasive tests: Fibrosis-4, aspartate aminotransferase (AST)-to-platelet ratio index (APRI), AST-to-alanine aminotransferase (ALT) ratio (AAR), APRI, FibroQ and Model For End-Stage Liver Disease (MELD) score. Pearson correlation coefficients analysis with was performed and p values < 0.05 were considered significant.

Results: In total, 13 patients (26%) fulfilled elastographic criteria for diagnosing liver cirrhosis. Liver SWE showed a significant correlation with spleen SWE (p < 0.05), AST (p<.001), ALT (p<.01), alkaline phosphatase (ALP) (p < 0.001), INR (p < 0.001) and MELD (p < 0.001), Fibrosis-4 (p < 0.001), APRI (p < 0.001) and Fibro-Q (p < 0.05). There was also a significant, negative correlation between Liver SWE and platelet count (p < 0.01) and serum albumin (p < 0.001). Notably, spleen SWE correlated with Fibrosis-4 (p < 0.05) and showed a negative correlation with platelet and serum albumin (p < 0.05).

Conclusions: Liver SWE could be of use in a non-invasive assessment of liver fibrosis in patients with AIH and its variants. The possible role of spleen SWE in the assessment of portal hypertension in AIH has to be established in larger cohorts of patients, however, present results might suggest that it can potentially serve as an additional modality in evaluation of patients suffering from liver autoimmune diseases.