Liver and spleen stiffness measurement using the new FibroScan module for prediction of esophageal varices and monitoring response to beta blockers in portal hypertension

Abstract

Background

This study aimed to assess the clinical use of the new FibroScan module for measurement of liver and spleen stiffness (LS and SS), comparing their usefulness in prediction of esophageal varices (EV) in patients with portal hypertension (PH) and their clinical value for monitoring response to non-selective beta blockers (NSBB) treatment in these cases. The study included 120 patients with compensated cirrhosis and PH, in addition to 30 healthy comparable controls. Based on gastrointestinal endoscopy, patients were classified into three groups: 48 without EV, 42 with small EV, and 30 with large varices needing treatment. Then, abdominal ultrasound and assessment of LS and SS using new FibroScan 630 Expert module were done for both patients and controls. Group 3 patients were then initiated on NSBB (propranolol), and follow-up of these parameters was done after 3 months.

Results

LS and SS were significantly increased in cirrhotic patients compared to controls and were positively correlated with ultrasonography parameters (spleen length and portal vein diameter). Moreover, they were significantly higher in patients with varices than in those without varices (compared to other noninvasive parameters), correlating with varices severity, and significantly decreased with NSBB treatment, especially SS.

Conclusion

Screening of cirrhotic patients for development of EV by elastography (LS and especially SS) using the new FibroScan machine seems to be an optimal method in clinical practice and superior to other noninvasive tests in the diagnosis, assessment of severity, and follow-up of response to treatment in these patients.