{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T22:15:18Z","timestamp":1773440118086,"version":"3.50.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Noninvasive assessment of high-risk varices (HRV) in idiopathic portal hypertension (IPH) is rare. The purpose of this study was to investigate the performance of spleen stiffness (SS) for evaluating the presence of HRV in IPH patients as compared the measurements in patients with hepatitis B virus (HBV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective single-center study was performed to evaluate the performance of SS for assessing HRV in IPH and HBV-infected patients, in comparison with liver stiffness (LS), spleen stiffness-to-liver stiffness ratio (SS\/LS), LS spleen-diameter-to-platelet-ratio score (LSPS), portal hypertension risk score (PH risk score) and varices risk score, by using upper gastrointestinal endoscopy (UGE) as the gold standard. Finally, 86 IPH and 102 HBV-infected patients were enrolled. UGE, two-dimensional shear wave elastography (2D-SWE) and laboratory data were collected, and noninvasive parameters were calculated. Analysis of receiver operating characteristic (ROC) curves was conducted to acquire the optimal area under the ROC curve (AUC) and cutoff value for predicting the presence of HRV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients with HRV, the significantly different parameters between IPH (34.9%) and HBV-infected patients (46.1%) were as follows: spleen size (diameter 18.5\u2009\u00b1\u20093.9\u00a0cm vs. 20.8\u2009\u00b1\u20092.7\u00a0cm), SS (50.2\u00a0kPa vs. 42.9\u00a0kPa), LS (11.1\u00a0kPa vs. 18.3\u00a0kPa) and PT (prothrombin time 15.1\u00a0s vs. 16.7\u00a0s). No statistically significant differences were found in liver function, platelet counts, spleen thickness and flow volumes in the portal venous system (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The AUCs of SS were 0.98 and 0.96 for predicting the presence of HRV in IPH (44.0\u00a0kPa cutoff value; 0.93 sensitivity; 0.96 specificity) and HBV-infected patients (35.2\u00a0kPa cutoff value; 1.00 sensitivity; 0.82 specificity), respectively, which were significantly better than other parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SS shows the optimal overall performance for predicting the presence of HRV in IPH and HBV-infected patients, in comparison with other noninvasive parameters.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12880-023-00977-9","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T09:36:47Z","timestamp":1675935407000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Performance of spleen stiffness measurement by 2D-shear wave elastography in evaluating the presence of high-risk varices: comparative analysis of idiopathic portal hypertension versus hepatitis B virus"],"prefix":"10.1186","volume":"23","author":[{"given":"Huihui","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhilin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Sang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"977_CR1","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver. EASL clinical practice guidelines: vascular diseases of the liver. J Hepatol. 2016;64(1):179\u2013202.","DOI":"10.1016\/j.jhep.2015.07.040"},{"issue":"6","key":"977_CR2","doi-asserted-by":"publisher","first-page":"2413","DOI":"10.1002\/hep.30132","volume":"68","author":"V Hern\u00e1ndez-Gea","year":"2018","unstructured":"Hern\u00e1ndez-Gea V, Baiges A, Turon F, et al. Idiopathic portal hypertension. Hepatology. 2018;68(6):2413\u201323.","journal-title":"Hepatology"},{"issue":"8","key":"977_CR3","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s00247-019-04396-3","volume":"49","author":"NA Northern","year":"2019","unstructured":"Northern NA, Dillman JR, Trout AT. Frequency of technical success of two-dimensional ultrasound shear wave elastography in a large pediatric and young adult cohort: a clinical effectiveness study. Pediatr Radiol. 2019;49(8):1025\u201331.","journal-title":"Pediatr Radiol"},{"issue":"6","key":"977_CR4","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1038\/ajg.2009.750","volume":"105","author":"BK Kim","year":"2010","unstructured":"Kim BK, Han KH, Park JY, et al. A liver stiffness measurement-based, noninvasive prediction model for high-risk esophageal varices in b-viral liver cirrhosis. Am J Gastroenterol. 2010;105(6):1382\u201390.","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"977_CR5","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1053\/j.gastro.2012.10.001","volume":"144","author":"A Berzigotti","year":"2013","unstructured":"Berzigotti A, Seijo S, Arena U, et al. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis. Gastroenterology. 2013;144(1):102\u201311.","journal-title":"Gastroenterology"},{"issue":"13","key":"977_CR6","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.1016\/j.cgh.2020.04.018","volume":"18","author":"Y Mendoza","year":"2020","unstructured":"Mendoza Y, Cocciolillo S, Murgia G, et al. Noninvasive markers of portal hypertension detect decompensation in overweight or obese patients with compensated advanced chronic liver disease. Clin Gastroenterol Hepatol. 2020;18(13):3017\u201325.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"977_CR7","first-page":"855","volume":"44","author":"S Susana","year":"2012","unstructured":"Susana S, Enric R, Rosa M, et al. Role of hepatic vein and transient elastography in the diagnosis of idiopathic portal hypertension. Dig Dis Sci. 2012;44:855\u201360.","journal-title":"Dig Dis Sci"},{"issue":"9","key":"977_CR8","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.1007\/s10620-019-05616-4","volume":"64","author":"DS Karagiannakis","year":"2019","unstructured":"Karagiannakis DS, Voulgaris T, Koureta E, Chloupi E, Papatheodoridis GV, Vlachogiannakos J. Role of spleen stiffness measurement by 2D-shear wave elastography in ruling out the presence of high-risk varices in cirrhotic patients. Dig Dis Sci. 2019;64(9):2653\u201360.","journal-title":"Dig Dis Sci"},{"issue":"10","key":"977_CR9","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1111\/hepr.13381","volume":"49","author":"S Yokoyama","year":"2019","unstructured":"Yokoyama S, Ishigami M, Honda T, et al. Spleen stiffness by 2-D shear wave elastography is the most accurate predictor of high-risk esophagogastric varices in children with biliary atresia. Hepatol Res. 2019;49(10):1162\u20138.","journal-title":"Hepatol Res"},{"issue":"2","key":"977_CR10","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1148\/radiol.14141210","volume":"275","author":"E Laure","year":"2015","unstructured":"Laure E, Pierre-Emmanuel R, Maxime R, et al. Prospective comparison of spleen and liver stiffness by using shear-wave and transient elastography for detection of portal hypertension in cirrhosis. Radiology. 2015;275(2):589\u201398.","journal-title":"Radiology"},{"issue":"4","key":"977_CR11","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1136\/gutjnl-2018-316204","volume":"68","author":"K Wang","year":"2019","unstructured":"Wang K, Lu X, Zhou H, et al. Deep learning radiomics of shear wave elastography significantly improved diagnostic performance for assessing liver fibrosis in chronic hepatitis B: a prospective multicentre study. Gut. 2019;68(4):729\u201341.","journal-title":"Gut."},{"issue":"3","key":"977_CR12","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1148\/radiol.2016160131","volume":"283","author":"Y Zhuang","year":"2017","unstructured":"Zhuang Y, Ding H, Zhang Y, Sun HC, Xu C, Wang WP. Two-dimensional shear-wave elastography performance in the noninvasive evaluation of liver fibrosis in patients with chronic hepatitis B: comparison with serum fibrosis indexes. Radiology. 2017;283(3):873\u201382.","journal-title":"Radiology"},{"issue":"7","key":"977_CR13","doi-asserted-by":"publisher","first-page":"2140","DOI":"10.3748\/wjg.v21.i7.2140","volume":"21","author":"ZQ Li","year":"2015","unstructured":"Li ZQ, LingHu EQ, Hu M, et al. Endoscopic measurement of variceal diameter. World J Gastroenterol. 2015;21(7):2140\u20136.","journal-title":"World J Gastroenterol"},{"issue":"2","key":"977_CR14","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jhepr.2019.05.003","volume":"1","author":"E Omar","year":"2019","unstructured":"Omar E, Johannes M, Indra NG, et al. Spleen stiffness to liver stiffness ratio significantly differs between ALD and HCV and predicts disease-specific complications. JHEP Rep. 2019;1(2):99\u2013106.","journal-title":"JHEP Rep"},{"issue":"8","key":"977_CR15","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.dld.2018.01.132","volume":"50","author":"G Stefania","year":"2018","unstructured":"Stefania G, Silvia N, Chiara P, et al. Natural history of patients with non cirrhotic portal hypertension: comparison with patients with compensated cirrhosis. Dig Liver Dis. 2018;50(8):839\u201344.","journal-title":"Dig Liver Dis"},{"issue":"3","key":"977_CR16","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1002\/hep.30628","volume":"70","author":"E Laure","year":"2019","unstructured":"Laure E, Jos\u00e9 FA, Audrey P, et al. Abdominal surgery in patients with idiopathic noncirrhotic portal hypertension: a multicenter retrospective study. Hepatology. 2019;70(3):911\u201324.","journal-title":"Hepatology"},{"issue":"8","key":"977_CR17","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1111\/jgh.14552","volume":"34","author":"YL Sun","year":"2018","unstructured":"Sun YL, Lan X, Shao C, Wang TL, Yang ZY. Clinical features of idiopathic portal hypertension in China: a retrospective study of 338 patients and literature review. J Gastroenterol Hepatol. 2018;34(8):1417\u201323.","journal-title":"J Gastroenterol Hepatol"},{"issue":"4","key":"977_CR18","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1038\/s41575-018-0097-3","volume":"16","author":"J Gracia-Sancho","year":"2018","unstructured":"Gracia-Sancho J, Marrone G, Fern\u00e1ndez-Iglesias A. Hepatic microcirculation and mechanisms of portal hypertension. Nat Rev Gastroenterol Hepatol. 2018;16(4):221\u201334.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"977_CR19","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1148\/radiol.2018171116","volume":"288","author":"TH Su","year":"2018","unstructured":"Su TH, Liao CH, Liu CH, et al. Acoustic radiation force impulse us imaging: liver stiffness in patients with chronic hepatitis B with and without antiviral therapy. Radiology. 2018;288(1):293\u20139.","journal-title":"Radiology"},{"issue":"2","key":"977_CR20","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1148\/radiol.2015150690","volume":"279","author":"T Yoshitaka","year":"2016","unstructured":"Yoshitaka T, Kazuhiro N, Youichi M, et al. Portal hypertension in patients with liver cirrhosis: diagnostic accuracy of spleen stiffness. Radiology. 2016;279(2):609\u201319.","journal-title":"Radiology"},{"issue":"4","key":"977_CR21","doi-asserted-by":"publisher","first-page":"687","DOI":"10.3748\/wjg.v23.i4.687","volume":"23","author":"A Kumar","year":"2017","unstructured":"Kumar A, Khan NM, Anikhindi SA, et al. Correlation of transient elastography with hepatic venous pressure gradient in patients with cirrhotic portal hypertension: a study of 326 patients from India. World J Gastroenterol. 2017;23(4):687\u201396.","journal-title":"World J Gastroenterol"},{"issue":"11\u201312","key":"977_CR22","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s00508-012-0190-5","volume":"124","author":"T Reiberger","year":"2012","unstructured":"Reiberger T, Ferlitsch A, Payer BA, et al. Noninvasive screening for liver fibrosis and portal hypertension by transient elastography a large single center experience. Wien Klin Wochenschr. 2012;124(11\u201312):395\u2013402.","journal-title":"Wien Klin Wochenschr"},{"issue":"10","key":"977_CR23","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/nrgastro.2009.149","volume":"6","author":"B Jaime","year":"2009","unstructured":"Jaime B, Juan GA, Annalisa B, Juan CGP. The clinical use of HVPG measurements in chronic liver disease. Nat Rev Gastroenterol Hepatol. 2009;6(10):573\u201382.","journal-title":"Nat Rev Gastroenterol Hepatol"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-023-00977-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-023-00977-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-023-00977-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T15:16:51Z","timestamp":1701875811000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-023-00977-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["977"],"URL":"https:\/\/doi.org\/10.1186\/s12880-023-00977-9","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]},"assertion":[{"value":"9 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study approved by the ethics committee of the First Affiliated Hospital of Fourth Military Medical University. All methods were carried out in accordance with relevant guidelines and regulations or declaration of Helsinki. The need for informed consent was waived by the ethics committee of the First Affiliated Hospital of Fourth Military Medical University, because of the retrospective nature of study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Authors do not have any competing interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"}}