Can Location of Stiffness Measurement Impact Spleen 2-Dimensional Shear Wave Elastography Measurement?

Abstract: Ultrasound-based spleen elastography is a promising surrogate to predict portal hypertension noninvasively. In contrast to defined standards for liver stiffness measurement, the standardized examination procedures for 2-dimensional (2D) shear wave elastography spleen elastography have not been established yet. The aim was to investigate the impact of location of stiffness measurement on 2D shear wave elastography spleen stiffness measurement (SSM). Patients with splenomegaly were enrolled. Both B-mode ultrasound and elastography of spleen were performed. For SSM, 3 regions were chosen for spleen measurement: lower pole region, central region, and the region between lower pole and center. Mean SSM value, success rate, and reliability predicators (standard deviation, standard deviation/mean, size of region of interest) were assessed. A total of 124 patients were included. For mean SSM value, there were no significant differences among 3 regions. Spleen stiffness measurement success rate in lower pole region, central region, and the region between them was 63.7% (79), 91.1% (113), and 78.2% (97), respectively. The success rate in the central region was significantly higher than that in the other 2 regions (P < 0.05). Reliability in the central region was also highest among the 3 regions. Location of stiffness measurement has a limited effect on SSM. Changing location of measurement will not influence mean stiffness value in spleen.