Evaluation of spleen stiffness in healthy volunteers using point shear wave elastography

Introduction and Objectives: This study aims to measure the values of spleen stiffness (SS) in healthy subjects, the inter-operator agreement in SS measurement, and to detect statistically significant correlations between SS and age, sex, weight, BMI, portal vein dynamics and splenic dimensions. Materials and methods: The study included 100 healthy volunteers who had no substantial alcohol intake (<30 g/daily for man, <20 g/daily women), were negative on hepatitis B, hepatitis C, HIV blood serology, and had any history of lymphoproliferative disorders. Abdominal ultrasound, liver and spleen elastography were performed on each patient to search for focal splenic lesions, bile tract or portal vein dilatation, moderate/severe liver steatosis, and to measure liver and spleen stiffness. Results: The mean value was 18.14 (+/- 3.08) kPa. In the group of men (n= 49), the mean was 17.73 (+/- 2.91) kPa, whereas in the group of women (n= 51) it was 16.72 (+/- 3.32) kPa. Statistical analyses showed no correlation between spleen stiffness and sex, age, weight, and BMI. Regarding their splenoportal axis, statistically significant differences in SS were found in the means of the two subgroups of subjects stratified by their portal flow velocity (p= 0.003) and spleen area (p < 0.001). Spearman's rank showed a weak association between SS and portal flow velocty (r= 0.271) and splenic area (r = -0.237). ICC showed excellent (0.96) inter-operator agreement and Bland-Altman plot demonstrated no systematic over/under-estimation of spleen stiffness values. Conclusions: Our results may serve as a reference point in the evaluation of SS especially in patients affected by advanced liver disease.