{"title":"经颈静脉肝内门静脉系统分流术后肝脾硬度的变化及其与预后的关系。","authors":"Xiao-Fang Liu, Xiao-Chun Huang, Qian-Jun Ye, Li-Jing Yuan, Gui-Fang Gao, Jin-Yu Li, Dui-Ping Feng","doi":"10.4240/wjgs.v17.i8.109884","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of transjugular intrahepatic portosystemic shunt (TIPS) on liver and spleen stiffness remains unclear, as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.</p><p><strong>Aim: </strong>To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.</p><p><strong>Methods: </strong>A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included. Liver and spleen stiffness was assessed using the sound touch quantify (STQ) value, determined <i>via</i> point shear wave elastography in ultrasound imaging. Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.</p><p><strong>Results: </strong>The liver STQ value demonstrated a marginally decreasing trend over time (<i>P</i> = 0.052), while the spleen STQ value showed a significantly decreasing trend (<i>P</i> = 0.025). Spleen STQ was positively correlated with portal pressure gradient (PPG) levels (r<sub>s</sub> = 0.327, <i>P</i> = 0.025). Cox regression analysis indicated that older age [hazard ratio (HR) = 1.063, 95%CI: 0.997-1.133, <i>P</i> = 0.060] and a higher liver STQ value (HR = 1.051, 95%CI: 1.009-1.095, <i>P</i> = 0.018) were associated with an increased mortality risk after TIPS. No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS. The liver STQ value [area under the receiver operating characteristic curve (AUC) = 0.724 (95%CI: 0.563-0.884)] showed superior predictive performance compared to the Child-Pugh score [AUC = 0.699 (95%CI: 0.529-0.870)] and was comparable to the model for end-stage liver disease score [AUC = 0.746 (95%CI: 0.591-0.902)].</p><p><strong>Conclusion: </strong>Following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"109884"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427020/pdf/","citationCount":"0","resultStr":"{\"title\":\"Changes in liver and spleen stiffness after transjugular intrahepatic portosystemic shunt and their relationship with prognosis.\",\"authors\":\"Xiao-Fang Liu, Xiao-Chun Huang, Qian-Jun Ye, Li-Jing Yuan, Gui-Fang Gao, Jin-Yu Li, Dui-Ping Feng\",\"doi\":\"10.4240/wjgs.v17.i8.109884\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The impact of transjugular intrahepatic portosystemic shunt (TIPS) on liver and spleen stiffness remains unclear, as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.</p><p><strong>Aim: </strong>To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.</p><p><strong>Methods: </strong>A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included. Liver and spleen stiffness was assessed using the sound touch quantify (STQ) value, determined <i>via</i> point shear wave elastography in ultrasound imaging. Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.</p><p><strong>Results: </strong>The liver STQ value demonstrated a marginally decreasing trend over time (<i>P</i> = 0.052), while the spleen STQ value showed a significantly decreasing trend (<i>P</i> = 0.025). Spleen STQ was positively correlated with portal pressure gradient (PPG) levels (r<sub>s</sub> = 0.327, <i>P</i> = 0.025). Cox regression analysis indicated that older age [hazard ratio (HR) = 1.063, 95%CI: 0.997-1.133, <i>P</i> = 0.060] and a higher liver STQ value (HR = 1.051, 95%CI: 1.009-1.095, <i>P</i> = 0.018) were associated with an increased mortality risk after TIPS. No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS. The liver STQ value [area under the receiver operating characteristic curve (AUC) = 0.724 (95%CI: 0.563-0.884)] showed superior predictive performance compared to the Child-Pugh score [AUC = 0.699 (95%CI: 0.529-0.870)] and was comparable to the model for end-stage liver disease score [AUC = 0.746 (95%CI: 0.591-0.902)].</p><p><strong>Conclusion: </strong>Following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.</p>\",\"PeriodicalId\":23759,\"journal\":{\"name\":\"World Journal of Gastrointestinal Surgery\",\"volume\":\"17 8\",\"pages\":\"109884\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427020/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4240/wjgs.v17.i8.109884\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v17.i8.109884","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Changes in liver and spleen stiffness after transjugular intrahepatic portosystemic shunt and their relationship with prognosis.
Background: The impact of transjugular intrahepatic portosystemic shunt (TIPS) on liver and spleen stiffness remains unclear, as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.
Aim: To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.
Methods: A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included. Liver and spleen stiffness was assessed using the sound touch quantify (STQ) value, determined via point shear wave elastography in ultrasound imaging. Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.
Results: The liver STQ value demonstrated a marginally decreasing trend over time (P = 0.052), while the spleen STQ value showed a significantly decreasing trend (P = 0.025). Spleen STQ was positively correlated with portal pressure gradient (PPG) levels (rs = 0.327, P = 0.025). Cox regression analysis indicated that older age [hazard ratio (HR) = 1.063, 95%CI: 0.997-1.133, P = 0.060] and a higher liver STQ value (HR = 1.051, 95%CI: 1.009-1.095, P = 0.018) were associated with an increased mortality risk after TIPS. No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS. The liver STQ value [area under the receiver operating characteristic curve (AUC) = 0.724 (95%CI: 0.563-0.884)] showed superior predictive performance compared to the Child-Pugh score [AUC = 0.699 (95%CI: 0.529-0.870)] and was comparable to the model for end-stage liver disease score [AUC = 0.746 (95%CI: 0.591-0.902)].
Conclusion: Following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.
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