Reference values of liver and spleen stiffness in a homogeneous cohort of healthy young adults assessed by two-dimensional Shear Wave Elastography

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Aim: To establish baseline liver and spleen stiffness values in healthy young adults using two-dimensional shear wave elastography (2D-SWE) and to evaluate differences according to gender and body mass index (BMI). Material and methods: A total of 400 healthy medical students (160 males and 240 females; mean age 22.2 years) underwent abdominal ultrasound and 2D-SWE using the Supersonic Aixplorer MultiWave system. Participants were stratified by BMI. As stiffness values were not normally distributed, results are presented as median and interquartile range (IQR), and non-parametric tests were applied. Results: The median liver stiffness was 5.25 kPa (IQR: 4.55–5.70) and was significantly higher in males (p=0.016), with no significant association with BMI. Median spleen stiffness was 15.9 kPa (IQR: 15.1–17.1) and was significantly higher in individuals with BMI >25 kg/m² (p<0.001). A weak but significant correlation was observed between BMI and spleen stiffness (r=0.147, p=0.003), while no correlation was found with liver stiffness. The prevalence of hepatic steatosis and gallstone disease was higher among overweight participants. Conclusion: 2D-SWE provides reliable reference values for liver and spleen stiffness in healthy young adults. Liver stiffness was significantly higher in males in univariate analysis but was not independently associated with sex in multivariable analysis. Spleen stiffness showed a significant association with BMI, although the underlying mechanisms remain to be elucidated.