Value of liver and spleen stiffness measured by two-dimensional shear wave elastography in diagnosing the severity of portal hypertension

Min WANG; Guanhua ZHANG; Lijuan FENG; Yuhong SUO; Fuliang HE; Xiangdong HU; Min LI; Yu WANG

doi:10.12449/JCH260512

Volume 42 Issue 5

May 2026

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Article Navigation > Journal of Clinical Hepatology > 2026 > 42(5): 1075-1082

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Value of liver and spleen stiffness measured by two-dimensional shear wave elastography in diagnosing the severity of portal hypertension

DOI: 10.12449/JCH260512

Min WANG^{1, 2, 3},
Guanhua ZHANG^{1, 2, 3},
Lijuan FENG^{1, 2, 3},
Yuhong SUO^{1, 2, 3},
Fuliang HE^{1, 2, 3},
Xiangdong HU⁴,
Min LI⁵,
Yu WANG^{1, 2, 3
,
,
,}

1.
Liver Research Center，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China
2.
State Key Laboratory of Digestive Health，Beijing 100050，China
3.
National Clinical Research Center for Digestive Diseases，Beijing 100050，China
4.
Department of Ultrasound，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China
5.
Department of Clinical Epidemiology and Evidence-based Medicine，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China

Research funding:

Capital’s Funds for Health Improvement and Research (CFH 2022-2-1104)

More Information

Corresponding author: WANG Yu， wangyuliver@ccmu.edu.cn （ORCID： 0000-0003-0057-9182）
Received Date: 2025-12-01
Accepted Date: 2026-02-14
Published Date: 2026-05-25

Abstract

Abstract

Objective To investigate the value of liver stiffness measurement （LSM） and spleen stiffness measurement （SSM） measured by two-dimensional shear wave elastography （2D-SWE） in the diagnosis of severe portal hypertension （SPH） and high-risk varices （HRV）， and to provide a basis for noninvasive assessment of portal hypertension. Methods A prospective study was conducted among 78 patients with cirrhotic portal hypertension who were treated in Liver Research Center of Beijing Friendship Hospital， Capital Medical University， from December 2019 to April 2023. According to hepatic venous pressure gradient （HVPG）， the patients were divided into 6 mmHg≤HVPG<12 mmHg group， 12 mmHg≤HVPG<20 mmHg group， and HVPG ≥20 mmHg group. All patients underwent gastroscopy and 2D-SWE within 1 week after HVPG measurement， and SWE-LSM and SWE-SSM measured by 2D-SWE were recorded. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. With HVPG and gastroscopy findings as the gold standard， the receiver operating characteristic （ROC） curve was plotted and the area under the ROC curve （AUC） was calculated to evaluate diagnostic performance， while the DeLong test was used for comparison of AUC. The Pearson or Spearman correlation analysis was used to investigate the correlation between variables， and the linear regression analysis and the Logistic regression analysis were used to investigate the influencing factors for HVPG and HRV. Results The mean HVPG was 18.1±6.4 mmHg for the patients enrolled in this study， and HRV was observed in 62 patients （79.5%）. Both SWE-LSM and SWE-SSM were significantly positively correlated with HVPG （r=0.413 and 0.633， both P<0.001）， with an AUC of 0.812 and 0.902， respectively， in the diagnosis of HVPG≥12 mmHg and an AUC of 0.804 and 0.789， respectively， in the diagnosis of HVPG≥20 mmHg （all P>0.05）. The multivariate linear regression analysis showed that SWE-SSM was an independent influencing factor for HVPG （β=0.17， P<0.001）. In the diagnosis of HRV， only SWE-SSM showed a significant positive correlation with HRV （r=0.432， P<0.001）， with a better diagnostic performance than SWE-LSM in terms of AUC （0.808 vs 0.642， Z=2.775， P=0.006）. The multivariate Logistic regression analysis showed that platelet count was an independent influencing factor for HRV （odds ratio=0.97， P=0.014）. Conclusion SWE-SSM is closely correlated with both HVPG and HRV， showing a good performance in the diagnosis of SPH and HRV， and therefore， it is expected to become an effective noninvasive tool for assessing portal hypertension.
- Liver Cirrhosis,
- Hypertension， Portal,
- Varicose Veins,
- Elasticity Imaging Techniques

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References(27)

References

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Value of liver and spleen stiffness measured by two-dimensional shear wave elastography in diagnosing the severity of portal hypertension

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Value of liver and spleen stiffness measured by two-dimensional shear wave elastography in diagnosing the severity of portal hypertension

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