Authors (including presenting author) :
Lam YY (1), Chan KTL(1), Lai SW(1), Yuen WH (1)
Affiliation :
(1) Department of Medicine & Geriatrics, Pok Oi Hospital
Keyword 1: :
Transient elastography
Keyword 2: :
Portal Vein Thromsis
Keyword 3: :
Spleen stiffness measurement
Introduction :
Portal vein thrombosis (PVT) is the formation of a thrombus that narrows or blocks the portal vein or its intrahepatic branches. It is a significant cause of portal hypertension (PH), next to cirrhosis, leads various complications in patients. In patients with cirrhosis, liver stiffness (LS) and spleen stiffness (SS) are strong predictors of significant PH. Currently, Computer tomography (CT) and upper endoscopy are used to monitor for the PVT progress and complications. Transient Elastography is seldom used in PVT patients because in non-cirrhotic patients with PVT, LS is usually normal or only slightly elevated. A pilot study was implanted from 2023 1Q to 2024 1Q in Department of Medical and Geriatrics, Pok Oi Hospital to evaluate the correlation of SS with PVT in non-cirrhotic patients.
Objectives :
Primary outcome: evaluate the correlation of SS with PVT
Secondary outcome: evaluate the correlation of SS with portal hypertension (PHT) in patients with PVT
Methodology :
We enrolled both PVT and normal patients for this study (January 2023– March 2024). We performed liver stiffness measurement (LSM) and SSM (dedicated software, 100 Hz-probe), baseline demographics, clinical and biochemical and laboratory parameters and CT within 3 months to both control and target groups (CT confirmed diagnosis of PVT). For those cirrhotic patients or with abnormal liver function would be excluded. Patient would have upper endoscopy afterward to look for the varices, complication of the portal hypertension.
Result & Outcome :
Total 91 (Control n=45 ; PVT n=48) patients were included in this study, divided into control and PVT group. By comparing with PVT and control group, higher SS in PVT group (27.9 kPa) compared with control group (16.9kPa) with normal range of LS. We also found that for the SS would much higher patient with developed PHT with varices or enlarged spleen after PVT. We found that SS measured by Transient Elastography (TE) increased with PVT compared with control group. SS maybe used to monitor PVT progression, reduction number of interval CT performed, reducing radiation, contrast exposure and healthcare cost burden. SS could also be a potential screening tools to stratify risk of PHT in PVT to avoid unnecessary upper endoscopy for EV screening.
