Spleen Stiffness on M agnetic Resonance Elastography for the Detection of Portal Hypertension: A Systematic Review and Meta Analysis

Background: chronic liver disease, complicated by portal hypertension (ph), may alter the extra-hepatic he-modynamic condition and spleen stiffness (ss). we aimed to evaluate the diagnostic accuracy of mri-based elastographic methods (mre) for detecting ph. methods: seven studies were included with reference to ss with regard to the prediction of ph patients. ma-jor outcomes considered for data extraction were diagnostic parameters for mri for concluding mild ph, clini-cally significant ph and severe ph. pubmed, scopus, google scholar, cochrane and science direct databases were used to extract the published literature through to may, 2021using the rayyan zotero and r softwares results: out of 587 studies extracted, 7 were selected based on inclusion and exclusion criteria. a quadas-2 assessment showed that all studies were clear in terms of patient selection and reference standard. a funnel plot showed that all the selected studies were outliers, indicating a low level of accuracy for the studies included. subgroup analysis, with reference to ss as a predictor of ph, revealed raw mean difference (rmd) of 7.78% (95% ci 5.23-10.34, p<0.01). the corresponding rmd observed for <60 years and >60 yr were 34.26% (95% ci 9.33- 59.20, i2=100%, 𝜏2=646.7688, p=0), and 46.92% (95% ci 20-59.33, i2=97%, 𝜏2=1003.023, p=0) re-spectively. the specificity and sensitivity noted for mri in determining ss were 0.721 and 0.747, respectively with an area-under the curve of 0.788. the estimated random effect models for specificity and sensitivity were 0.938 and 0.842, respectively. conclusion: the real-time mre has acceptable specificity and sensitivity for diagnosing ss.