Key result
Liver stiffness by 2D-SWE outperforms LSPS in detecting portal hypertension with ~0.91 AUC in rats.
Why the study?
Measurement of hepatic venous pressure gradients is the gold standard for assessing portal hypertension but is invasive with potential complications, motivating evaluation of noninvasive methods in NAFLD models.
Does two-dimensional shear wave elastography improve the diagnosis of portal hypertension compared to composite scores in NAFLD rat models?
Does two-dimensional shear wave elastography improve the diagnosis of portal hypertension compared to composite scores in NAFLD rat models?
Absolute Event Rate: 0.906% vs 0.793%
p-value: p=0.047
Two-dimensional shear wave elastography provides a more accurate, noninvasive method for diagnosing portal hypertension in NAFLD compared to traditional composite scores in a rat model.
2D-SWE LSM/SSM outperform composites for PH diagnosis in NAFLD rats; leaves open translation to human practice.
Background: Measurement of hepatic venous pressure gradients is the gold standard for assessing portal hypertension (PH) but is invasive with potential complications. We aimed to assess the performance in liver and spleen stiffness measurement (LSM and SSM, respectively) by two-dimensional shear wave elastography (2D-SWE) and composite scores including liver stiffness-spleen diameter to platelet ratio score (LSPS), platelet (PLT) count/spleen diameter ratio (PSR), aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR), and AST-to-PLT ratio index (APRI) for diagnosing PH in nonalcoholic fatty liver disease (NAFLD) rat models. Methods: Animal models with PH in NAFLD were established in 65 rats, which then underwent 2D-SWE measurements. Morphological and biological parameters were collected for calculation of four composite scores. Correlations of noninvasive methods with portal venous pressure were evaluated by Spearman correlation analysis. The area under the receiver operating characteristic curve (AUC) was used to assess the performance of noninvasive methods in predicting PH. Results: > 0.05). Conclusions: LSM and SSM by 2D-SWE can be used as promising noninvasive parameters for diagnosing PH in NAFLD and have higher accuracy than composite scores. The combined models, compared to LSM and SSM, did not significantly improve the performance in diagnosing PH.
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Dong et al. (2022) studied Nonalcoholic fatty liver disease and portal hypertension (n=79). Two-dimensional shear wave elastography (2D-SWE) vs. Composite scores (LSPS, PSR, AAR, APRI) was evaluated on Area under the receiver operating characteristic curve (AUC) for diagnosing portal hypertension (95% CI 0.841-0.970, p=0.047). Liver stiffness measurement by 2D-SWE accurately diagnosed portal hypertension in NAFLD rats with an AUC of 0.906, demonstrating significantly higher diagnostic performance than the LSPS composite score.
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