{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:11:17Z","timestamp":1781604677872,"version":"3.54.5"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009558","name":"University Natural Science Research Project of Anhui Province","doi-asserted-by":"publisher","award":["KJ2020A0436"],"award-info":[{"award-number":["KJ2020A0436"]}],"id":[{"id":"10.13039\/501100009558","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The current study aimed to explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE) to predict hypersplenism occurrence in Wilson\u2019s disease (WD) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety WD patients were enrolled in this prospective study between May 2018 and December 2018. Baseline clinical data and ultrasound imaging including 2D-SWE liver stiffness of WD patients were collected. After enrollment, patients had follow-ups for 24\u00a0months or until they developed hypersplenism. The hypersplenism risk factors were determined using Cox regressions and receiver operating characteristic curves (ROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-nine (32.2%) patients developed hypersplenism. Age, portal vein diameter, and liver stiffness were independent hypersplenism risk factors in WD patients. The cutoff value of liver stiffness to predict hypersplenism was 10.45\u00a0kPa, with sensitivity and specificity of 75.9% and 73.8%, respectively. Patients were divided into two groups according to liver stiffness:\u2009\u2265\u200910.45\u00a0kPa (57.9% with hypersplenism) or\u2009&lt;\u200910.45\u00a0kPa (13.5% with hypersplenism). The median time between enrollment and hypersplenism development was 15\u00a0months vs. 22\u00a0months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for the two groups, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The measurement of liver stiffness by 2D-SWE can be a reliable hypersplenism predictor in WD patients. Therefore, dynamic monitoring of WD patients using 2D-SWE is crucial for the early diagnosis of hypersplenism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-022-00749-x","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T07:02:38Z","timestamp":1644562958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Liver stiffness assessed by real-time two-dimensional shear wave elastography predicts hypersplenism in patients with Wilson\u2019s disease: a prospective study"],"prefix":"10.1186","volume":"22","author":[{"given":"Jiajia","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minxia","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanting","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"issue":"6","key":"749_CR1","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.clinre.2018.03.007","volume":"42","author":"A Poujois","year":"2018","unstructured":"Poujois A, Woimant F. Wilson\u2019s disease: a 2017 update. Clin Res Hepatol Gastroenterol. 2018;42(6):512\u201320.","journal-title":"Clin Res Hepatol Gastroenterol"},{"issue":"3","key":"749_CR2","first-page":"179","volume":"13","author":"L Gheorghe","year":"2004","unstructured":"Gheorghe L, Popescu I, Iacob S, Gheorghe C, Vaidan R, Constantinescu A, et al. Wilson\u2019s Disease: a challenge of diagnosis. The 5-year experience of a tertiary centre. Rom J Gastroenterol. 2004;13(3):179\u201385.","journal-title":"Rom J Gastroenterol"},{"key":"749_CR3","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/B978-0-444-63625-6.00012-4","volume":"142","author":"EA Roberts","year":"2017","unstructured":"Roberts EA, Socha P. Wilson disease in children. Handb Clin Neurol. 2017;142:141\u201356.","journal-title":"Handb Clin Neurol"},{"issue":"3","key":"749_CR4","doi-asserted-by":"publisher","first-page":"378","DOI":"10.3748\/wjg.v25.i3.378","volume":"25","author":"HJ Zhong","year":"2019","unstructured":"Zhong HJ, Sun HH, Xue LF, McGowan EM, Chen Y. Differential hepatic features presenting in Wilson disease-associated cirrhosis and hepatitis B-associated cirrhosis. World J Gastroenterol. 2019;25(3):378\u201387.","journal-title":"World J Gastroenterol"},{"issue":"91\u201392","key":"749_CR5","first-page":"778","volume":"56","author":"T Ikegami","year":"2009","unstructured":"Ikegami T, Soejima Y, Taketomi A, Kawanaka H, Yoshizumi T, Shimada M, et al. Hypersplenism after living donor liver transplantation. Hepatogastroenterology. 2009;56(91\u201392):778\u201382.","journal-title":"Hepatogastroenterology"},{"issue":"4","key":"749_CR6","first-page":"e014569","volume":"10","author":"LY Li","year":"2015","unstructured":"Li LY, Yang WM, Chen HZ, Wu YH, Fang X, Zhang J, et al. Successful splenectomy for hypersplenism in Wilson\u2019s disease: a single center experience from China. PLoS ONE. 2015;10(4):e014569.","journal-title":"PLoS ONE"},{"issue":"4","key":"749_CR7","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1177\/1553350608324931","volume":"15","author":"EM Targarona","year":"2008","unstructured":"Targarona EM. Portal vein thrombosis after laparoscopic splenectomy: the size of the risk. Surg Innov. 2008;15(4):266\u201370.","journal-title":"Surg Innov"},{"issue":"6","key":"749_CR8","first-page":"383","volume":"39","author":"P Jones","year":"2010","unstructured":"Jones P, Leder K, Woolley I, Cameron P, Cheng A, Spelman D. Postsplenectomy infection\u2014strategies for prevention in general practice. Aust Fam Phys. 2010;39(6):383\u20136.","journal-title":"Aust Fam Phys"},{"issue":"2","key":"749_CR9","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1080\/08941939.2016.1278058","volume":"31","author":"LY Li","year":"2018","unstructured":"Li LY, Chen HZ, Bao YC, Yu QS, Yang WM. Successful treatment of hypersplenism in Wilson\u2019s disease by partial splenic embolization. J Investig Surg. 2018;31(2):75\u201381.","journal-title":"J Investig Surg"},{"key":"749_CR10","doi-asserted-by":"publisher","first-page":"S105","DOI":"10.1016\/j.jvir.2014.12.284","volume":"26","author":"JD Collins","year":"2015","unstructured":"Collins JD, Ayache Bou JM, Semaan E, Salem R, Carr JC, Markl M, et al. Quantitative assessment of splenic hemodynamics at 4D flow MRI to diagnose hypersplenism associated thrombocytopenia. J Vasc Interv Radiol. 2015;26:S105\u20136.","journal-title":"J Vasc Interv Radiol"},{"issue":"9","key":"749_CR11","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1007\/s11605-017-3443-9","volume":"21","author":"Y Shen","year":"2017","unstructured":"Shen Y, Zhou C, Zhu G, Shi G, Zhu X, Huang C, et al. Liver stiffness assessed by shear wave elastography predicts postoperative liver failure in patients with hepatocellular carcinoma. J Gastrointest Surg. 2017;21(9):1471\u20139.","journal-title":"J Gastrointest Surg"},{"issue":"6","key":"749_CR12","doi-asserted-by":"publisher","first-page":"852","DOI":"10.5009\/gnl16521","volume":"11","author":"JY Jeong","year":"2017","unstructured":"Jeong JY, Sohn JH, Sohn W, Park CH, Kim TY, Jun DW, et al. Role of shear wave elastography in evaluating the risk of hepatocellular carcinoma in patients with chronic hepatitis B. Gut Liver. 2017;11(6):852\u20139.","journal-title":"Gut Liver"},{"issue":"6","key":"749_CR13","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1097\/MPG.0000000000001517","volume":"64","author":"HM Yoon","year":"2017","unstructured":"Yoon HM, Kim SY, Kim KM, Oh SH, Ko GY, Park Y, et al. Liver stiffness measured by shear-wave elastography for evaluating intrahepatic portal hypertension in children. J Pediatr Gastroenterol Nutr. 2017;64(6):892\u20137.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"749_CR14","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1016\/j.jhep.2014.12.007","volume":"62","author":"B Procopet","year":"2015","unstructured":"Procopet B, Berzigotti A, Abraldes JG, Turon F, Hernandez-Gea V, Garcia-Pagan JC, et al. Real-time shear-wave elastography: applicability, reliability and accuracy for clinically significant portal hypertension. J Hepatol. 2015;62(5):1068\u201375.","journal-title":"J Hepatol"},{"issue":"5","key":"749_CR15","doi-asserted-by":"publisher","first-page":"470","DOI":"10.3325\/cmj.2015.56.470","volume":"56","author":"I Grgurevic","year":"2015","unstructured":"Grgurevic I, Bokun T, Mustapic S, Trkulja V, Heinzl R, Banic M, et al. Real-time two-dimensional shear wave ultrasound elastography of the liver is a reliable predictor of clinical outcomes and the presence of esophageal varices in patients with compensated liver cirrhosis. Croat Med J. 2015;56(5):470\u201381.","journal-title":"Croat Med J"},{"issue":"3","key":"749_CR16","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","volume":"63","author":"R de Franchis","year":"2015","unstructured":"de Franchis R, Baveno VIF. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63(3):743\u201352.","journal-title":"J Hepatol"},{"issue":"5","key":"749_CR17","doi-asserted-by":"publisher","first-page":"737","DOI":"10.3390\/diagnostics11050737","volume":"11","author":"R Fofiu","year":"2021","unstructured":"Fofiu R, Bende F, Popescu A, Sirli R, Miutescu B, Sporea I. Assessing Baveno VI criteria using liver stiffness measured with a 2D-shear wave elastography technique. Diagnostics (Basel). 2021;11(5):737.","journal-title":"Diagnostics (Basel)"},{"issue":"3","key":"749_CR18","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1034\/j.1600-0676.2003.00824.x","volume":"23","author":"P Ferenci","year":"2003","unstructured":"Ferenci P, Caca K, Loudianos G, Mieli-Vergani G, Tanner S, Sternlieb I, et al. Diagnosis and phenotypic classification of Wilson disease. Liver Int. 2003;23(3):139\u201342.","journal-title":"Liver Int"},{"issue":"2","key":"749_CR19","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1148\/radiol.2020192437","volume":"296","author":"RG Barr","year":"2020","unstructured":"Barr RG, Wilson SR, Rubens D, Garcia-Tsao G, Ferraioli G. Update to the society of radiologists in ultrasound liver elastography consensus statement. Radiology. 2020;296(2):263\u201374.","journal-title":"Radiology"},{"issue":"1","key":"749_CR20","doi-asserted-by":"publisher","first-page":"46","DOI":"10.2214\/AJR.16.17620","volume":"209","author":"EJ Keller","year":"2017","unstructured":"Keller EJ, Kulik L, Stankovic Z, Lewandowski RJ, Salem R, Carr JC, et al. JOURNAL CLUB: four-dimensional flow MRI-based splenic flow index for predicting cirrhosis-associated hypersplenism. AJR Am J Roentgenol. 2017;209(1):46\u201354.","journal-title":"AJR Am J Roentgenol"},{"issue":"3\u20134","key":"749_CR21","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1023\/B:MEBR.0000043973.10494.85","volume":"19","author":"P Ferenci","year":"2004","unstructured":"Ferenci P. Pathophysiology and clinical features of Wilson disease. Metab Brain Dis. 2004;19(3\u20134):229\u201339.","journal-title":"Metab Brain Dis"},{"issue":"9","key":"749_CR22","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1002\/jhbp.379","volume":"23","author":"H Maruyama","year":"2016","unstructured":"Maruyama H, Kobayashi K, Kiyono S, Sekimoto T, Kanda T, Yokosuka O. Two-dimensional shear wave elastography with propagation-based reliability assessment for grading hepatic fibrosis and portal hypertension. J Hepatobiliary Pancreat Sci. 2016;23(9):595\u2013602.","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"1","key":"749_CR23","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.ultrasmedbio.2020.09.004","volume":"47","author":"R Fofiu","year":"2021","unstructured":"Fofiu R, Bende F, Popescu A, Sirli R, Lupusoru R, Ghiuchici AM, et al. Spleen and liver stiffness for predicting high-risk varices in patients with compensated liver cirrhosis. Ultrasound Med Biol. 2021;47(1):76\u201383.","journal-title":"Ultrasound Med Biol"},{"issue":"5","key":"749_CR24","doi-asserted-by":"publisher","first-page":"W185","DOI":"10.2214\/AJR.17.18367","volume":"210","author":"CH Suh","year":"2018","unstructured":"Suh CH, Kim KW, Park SH, Lee SS, Kim HS, Tirumani SH, et al. Shear wave elastography as a quantitative biomarker of clinically significant portal hypertension: a systematic review and meta-analysis. Am J Roentgenol. 2018;210(5):W185\u201395.","journal-title":"Am J Roentgenol"},{"key":"749_CR25","doi-asserted-by":"publisher","first-page":"525","DOI":"10.5334\/tohm.435","volume":"8","author":"A Aggarwal","year":"2018","unstructured":"Aggarwal A, Bhatt M. Advances in treatment of Wilson disease. Tremor Other Hyperkinet Mov (N Y). 2018;8:525.","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"4","key":"749_CR26","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.1055\/a-0641-0076","volume":"38","author":"CF Dietrich","year":"2017","unstructured":"Dietrich CF, Bamber J, Berzigotti A, Bota S, Cantisani V, Castera L, et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version). Ultraschall Med. 2017;38(4):e48.","journal-title":"Ultraschall Med"},{"issue":"3","key":"749_CR27","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s13760-012-0025-1","volume":"112","author":"DB Kozic","year":"2012","unstructured":"Kozic DB, Semnic R, Petrovic I, Svetel M, Ostojic J, Kostic VS. Are irreversible morphological [corrected] signs of portal hypertension in neurological form of Wilson\u2019s disease associated with treatment delay? A pilot study. Acta Neurol Belg. 2012;112(3):261\u20134.","journal-title":"Acta Neurol Belg"},{"issue":"11","key":"749_CR28","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.1002\/jum.15334","volume":"39","author":"J Hwang","year":"2020","unstructured":"Hwang J, Yoon HM, Jung AY, Lee JS, Kim KM, Oh SH, et al. Diagnostic performance of ultrasound elastography and serologic fibrosis indices for evaluation of hepatic involvement in Wilson disease. J Ultrasound Med. 2020;39(11):2231\u201342.","journal-title":"J Ultrasound Med"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00749-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-022-00749-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00749-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T07:05:13Z","timestamp":1644563113000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-022-00749-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,11]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["749"],"URL":"https:\/\/doi.org\/10.1186\/s12880-022-00749-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-612351\/v1","asserted-by":"object"}]},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,11]]},"assertion":[{"value":"19 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In this study, all procedures abided by the protocol of the First Affiliated Hospital, Anhui University of Chinese Medicine. The institutional review board approved this study. Ethical approval was approved by the Ethical Committee of the hospital, and obtained ethics approval in written (2018AH-08). Written informed consent to participate was obtained from all the patients for publication of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Participants of this study have provided written consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there are no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"25"}}