Liver and spleen elastography as predictor of portal hypertension and esophageal varices.

Liver stiffness is related to the degree of hepatic fibrosis which ultimately causes portal hypertension and gastroesophageal varices. Variceal bleeding is a worrisome and potentially fatal complication of cirrhosis, primary prophylaxis has demonstrated a reduction in decompensation and mortality. Portal hypertension and esophageal varices needing treatment could be predicted through noninvasive methods, including elastography, that evaluates the mechanical properties of liver or spleen tissue in concordance to the propagation of mechanical waves. The accurate prediction of the risk of gastroesophageal varices could spare unnecessary endoscopies in patients with low probability of finding varices needing treatment. In the current review, we discuss the elastography modalities available and the current evidence for its implementation in daily clinical practice.