Diagnostic Value of Point Shear Wave Elastography (pSWE) of the Spleen for Assessment of Liver Fibrosis in Patients with Chronic Viral Hepatitis

Abstract

In recent years spleen stiffness (SS), assessed by point shear wave elastography (pSWE) has been a topic of interest as a more accurate indicator for the diagnosis of liver fibrosis in chronic viral hepatitis. For the first time in Bulgaria, a comprehensive research on the stiffness of the liver and spleen has been performed by pSWE in patients with chronic viral hepatitis, as well as evaluation of their correlation with the histological assessment of liver fibrosis. The aim of the research is to establish spleen and liver stiffness in patients with chronic viral hepatitis and their correlation with intermediate stages of liver fibrosis diagnosed histologically after biopsy. For the period 2018–2020, ninety patients with chronic viral hepatitis B and C (mean age 46.20±14.55) from the department of Gastroenterology, University hospital Kaspela, Plovdiv, Bulgaria, have been examined, by abdominal ultrasound, pSWE of the liver and spleen, histological evaluation of liver fibrosis, data study on the presence of  esophageal varices and ascites. The liver stiffness (LS) value distinguishing between F1 and F2 was 1.86 m/s (rs=0.769, 95% CI: 0.652–0.850, p<0.001). The spleen stiffness (SS) value distinguishing between F1 and F2 was 2.95 m/s (rs=0.838, 95% CI: 0.749–0.898, p<0.001). Liver stiffness is significantly affected by BMI, which reduces its diagnostic potential in obese patients. Spleen stiffness measured by pSWE can be used in the diagnosis of intermediate stages of liver fibrosis in patients with chronic hepatitis B and C.