Point Shear Wave Elastography to Evaluate and Monitor Changing Portal Venous Pressure in Patients with Decompensated Cirrhosis

This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with portal venous pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP. We also analyzed whether change in SWV (ΔSWV) correlates with ΔPVP. The correlations were assessed with Spearman's rank correlation coefficients. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic capacity of ΔSWV. Spleen stiffness (SS) was positively correlated with PVP before and after TIPS (p < 0.002), although no correlation between liver stiffness and PVP was detected. A strong relationship between ΔSWV in SS and ΔPVP change in portal hypertension (r = 0.871) was also found in the overall population. The area under the ROC curve for the diagnosis of TIPS technical success was 0.869 and at a ΔSWV cut-off value of 0.36 m/s sensitivity was 77%. Measurement of SS can be used for non-invasive assessment and monitoring of PVP in patients with decompensated cirrhosis.