Evaluation of liver and spleen in chronic myeloproliferative disorders with shear wave elastography

ABSTRACT PURPOSE: We aim to investigate the role of elastography techique in diagnostic processes and treatment monitoring by revealing liver and spleen stiffness in different chronic myeloproliferative disease types using SW elastography, comparing these datas with fibrosis degree in bone marrow and also clinical-hematological parameters between patients and healthy volunteers. MATERIALS AND METHODS: 35 patients newly diagnosed of chronic myeloproliferative disease who were referred to Ege University Medicine Faculty Hospital, department of hematology between June 2013 and August 2015 and 31 healthy control subjects were enrolled prospectively to our study. Anatomical and shear wave sonoelastography including upper abdomen ulrasound of each subject was performed with Virtual Touch Tissue QuantificationTM method based on noninvasive acoustic radiation force imaging (ARFI) technology using Siemens Acuson S2000 USG device. Clinical, laboratory (hemograms, peripheral blood, biochemistry, medical genetics records, bone marrow aspiration biopsy) findings of the subjects were reviewed. Laboratory parameters, ultrasound and sonoelastography datas of liver and spleen, ratio of spleen/liver Vs were all compared. FINDINGS: Mean Vs value of liver in patients with chronic myeloproliferative disease was significantly higher than in control group (p=0.001). In contrast there was not statistically significance for mean spleen Vs values between two groups. In addition patients group has significantly lower mean rate of spleen Vs/liver Vs than controls (p<0.001). On the other hand while mean liver and spleen Vs values of patients with ET or PV in chronic myeloproliferative disease subgroups and controls did not differ, mean liver Vs value was significantly higher in subgroup of patients with primary myelofybrosis comparing with the healthy subjects (p<0.001). There was moderate correlation between spleen length and spleen Vs values in patients(r=0.428, p=0.018). There was good lineer correlation between white blood cell count and liver Vs values in patient group, and very good lineer correlation between hematocrite level and liver Vs (r=0.854, p=0.007) among patients with myelofibrosis .( r=0.472, p=0.006). Also seen very good negative correlation between hemoglobin and liver Vs ( r=-0.781 p=0.013) and good negative correlation ( r=-0.709 p=0.032) between hematocrite level and liver Vs values among patients with polycythemia vera. CONCLUSION: Controled and randomised trials with larger population and longer follow-up periods in chronic myeloproliferative disorders, may lead to clarify the relationship between spleen stiffness and disease, and may also show if there is a role of liver elasticity in prediction of prognosis in patients with chronic myeloproliferative disease.