Portal hypertension (PHT) is a serious consequence of chronic liver diseases like cirrhosis, characterized by elevated pressure in the portal vein—a critical blood vessel that transports blood from the intestines, spleen, and stomach to the liver. This condition can lead to severe complications such as internal bleeding and liver failure. Currently, the most accurate diagnosis of PHT involves an invasive procedure to measure pressure within the liver, which is uncomfortable and carries some risk of complications. However, a new, non-invasive method known as spleen stiffness measurement (SSM) shows promise for diagnosing PHT safely and effectively. SSM assesses the stiffness of the spleen, an organ near the stomach that filters blood and combats infection, using ultrasound-like sound waves. In the presence of PHT, the spleen becomes enlarged and stiffer, and SSM provides a painless way to detect these changes.
Research indicates that SSM may be highly accurate, potentially surpassing liver stiffness measurements in some cases because the spleen may reflect changes in portal pressure more directly than the liver. This innovation in testing could replace invasive diagnostics, making it safer and more comfortable for patients. Additionally, SSM could allow for earlier PHT screening in patients with chronic liver disease, improving the chances for timely intervention and prevention of complications. SSM could also play a crucial role in monitoring treatment progress by allowing doctors to track changes in spleen stiffness over time, helping them evaluate responses to therapies like medication or procedures such as transjugular intrahepatic portosystemic shunt (TIPS).
Although SSM is promising, further studies are needed to confirm its accuracy across diverse patient groups and to refine cut-off values for PHT diagnosis. Overall, SSM has the potential to transform PHT diagnosis and management, improving patient care, reducing healthcare costs, and potentially saving lives.
