Spleen stiffness by ultrasound elastography

This chapter reviews the use of spleen stiffness measurements (SSM) by ultrasound elastography technique. SSM represents a new, useful, non-invasive tool able to help the hepatologist in the management of the patient with liver diseases and different clinical presentations. In recent years, spleen parameters have been taken more and more into consideration in order to provide additional information for the evaluation of liver diseases; indeed, SSM has been demonstrated to correlate with the presence and degree of portal hypertension (PH) both in cirrhotic and non-cirrhotic patients, as well as with the presence and degree of esophageal varices, and as a predictor of clinical decompensation and even of mortality in cirrhotic patients. We first discuss the physiopathological rationale which led to the use of ultrasound elastography (routinely employed in assessing liver stiffness) in the context of spleen stiffness. We also review the different ultrasound elastography techniques currently available, and we discuss clinical applications of SSM in cirrhotic and non-cirrhotic portal hypertension and its associated complications.