Portal hypertension correlates with splenic stiffness as measured with MR elastography.

Publication Type:

Journal Article

Source:

Journal of magnetic resonance imaging : JMRI, Volume 34, Issue 1, p.79-87 (2011)

Keywords:

Animalsdigestive disease, digestive deseases Cholestasisdigestive disease, digestive deseases Disease Models, Animaldigestive disease, digestive deseases Dogsdigestive disease, digestive deseases Elasticity Imaging Techniquesdigestive disease, digestive deseases Fibrosisdigestive disease, digestive deseases Humansdigestive disease, digestive deseases Hypertension, Portaldigestive disease, digestive deseases Liverdigestive disease, digestive deseases Magnetic Resonance Imagingdigestive disease, digestive deseases Pressuredigestive disease, digestive deseases Regression Analysisdigestive disease, digestive deseases Spleendigestive disease, digestive deseases Time Factors

Abstract:

PURPOSE: To investigate the correlation between MR elastography (MRE) assessed spleen stiffness and direct portal vein pressure gradient (D-HVPG) measurements in a large animal model of portal hypertension.

MATERIALS AND METHODS: Cholestatic liver disease was established in adult canines by common bile duct ligation. A spin echo based echo planar imaging (EPI) MRE sequence was used to acquire three-dimensional/three axis (3D/3-axis) abdominal MRE data at baseline, 4 weeks, and 8 weeks. Liver biopsies, blood samples, and D-HVPG measurements were obtained simultaneously.

RESULTS: Animals developed portal hypertension (D-HVPG: 11.0 ± 5.1 mmHg) with only F1 fibrosis after 4 weeks. F3 fibrosis was confirmed after 8 weeks despite no further rise in portal hypertension (D-HVPG: 11.3 ± 3.2 mmHg). Mean stiffnesses of the spleen increased over two-fold from baseline (1.72 ± 0.33 kPa) to 4 weeks (3.54 ± 0.31 kPa), and stabilized at 8 weeks (3.38 ± 0.06 kPa) in a pattern consistent with changes in portal pressure. A positive correlation was observed between spleen stiffness and D-HVPG (r(2) = 0.86; P < 0.01).

CONCLUSION: These findings indicate a temporal relationship between portal hypertension and the development of liver fibrosis in a large animal model of cholestatic liver disease. The observed direct correlation between spleen stiffness and D-HVPG suggest a noninvasive MRE approach to diagnose and screen for portal hypertension.