Liver and Spleen Stiffness in Patients with Extrahepatic Portal Vein Obstruction

Liver and Spleen Stiffness in Patients with Extrahepatic Portal Vein Obstruction

Purpose: To evaluate liver stiffness (LS) and spleen stiffness (SS) in patients with extrahepatic portal vein obstruction (EHPVO).

Materials and Methods: Institutional research board approval and informed consent were obtained. LS and SS were measured in 65 consecutive patients with EHPVO. Patients underwent endoscopy, liver biopsy, liver function tests, abdominal ultrasonography, a detailed history, and examination. LS and SS measurements were also obtained in 50 age-matched healthy control subjects. Comparisons were made by using the Student t test, Mann-Whitney test for quantitative data, and χ² or Fisher exact test for qualitative data.

Results: Sixty-five patients with EHPVO (with a bleed, n = 45; without a bleed, n = 20; mean age, 25.4 years ± 10.7 [standard deviation]; 29 men, 36 women) were enrolled. Twenty-two (34%) had hypersplenism. LS (P = .001) and SS (P = .01) were higher in patients with EHPVO (6.7 kPa ± 2.3 and 51.7 kPa ± 21.5, respectively) than in control subjects (4.6 kPa ± 0.7 and 16.0 kPa ± 3.0, respectively). Patients who had a bleed had higher SS than did those without a bleed (60.4 kPa ± 5.4 vs 30.3 kPa ± 14.2, P = .01). There was no significant difference in age (26.7 years ± 10.4 vs 22.5 years ± 9.8, P = .8) and median duration of disease (4.5 years [range, 1–26 years] vs 6.0 years [range, 1–22 years], P = .23) in patients with a bleed versus those without. With a cutoff of 5.9 kPa for LS, sensitivity and specificity for detection of a variceal bleed were 67% and 75%, respectively. An SS cutoff of 42.8 kPa yielded sensitivity and specificity of 88% and 94%, respectively.

Conclusion: LS and SS were higher in patients with EHPVO than in control subjects, and patients with a history of a bleed had a higher SS than did those without a bleed.

© RSNA, 2012

Invasive Breast Cancer: SWE Findings and Histologic Factors

Invasive Breast Cancer: Relationship between Shear-wave Elastographic Findings and Histologic Prognostic Factors

Purpose: To compare the histologic prognostic feature of invasive breast cancer with mean stiffness as measured with shear-wave elastography.

Materials and Methods: This retrospective study was exempted from ethical committee review. Patient consent for use of images for research was obtained. The study group comprised 101 consecutive women (age range, 38–91 years) with solid lesions identified during routine breast ultrasonography (US) performed between April 2010 and March 2011 and subsequently confirmed at histologic examination to be invasive cancers. Four elastographic images in two orthogonal planes were obtained of each lesion, and mean stiffness values were obtained from each image. Histologic findings following surgery were used for comparison, namely histologic grade, tumor type, invasive size, vascular invasion status, and lymph node status. Relationship between mean stiffness and histologic parameters was investigated by using a general linear model and multiple regression analysis.

Results: High histologic grade (P < .0001), large invasive size (P < .0001), lymph node involvement (P < .0001), tumor type (P < .0001), and vascular invasion (P = .0077) all showed statistically significant positive association with high mean stiffness values. Multiple linear regression indicated that invasive size is the strongest pathologic determinant of mean stiffness (P < .0001), with histologic grade also having significant influence (P = .022).

Conclusion: In this study, breast cancers with higher mean stiffness values at shear-wave elastography had poorer prognostic features.

© RSNA, 2012