Identifying Compensated Advanced Chronic Liver Disease: When (Not) to Start Screening for Varices and Clinically Significant Portal Hypertension

2016 ◽  
pp. 39-49 ◽  
Author(s):  
Salvador Augustin ◽  
Mónica Pons ◽  
Begoña Santos ◽  
Meritxell Ventura ◽  
Joan Genescà
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Clinically Significant

Liver Stiffness Assessed by Ultrasound Shear Wave Elastography from General Electric Accurately Predicts Clinically Significant Portal Hypertension in Patients with Advanced Chronic Liver Disease

2019 ◽  
Vol 41 (05) ◽  
pp. 526-533
Author(s):  
Horia Stefanescu ◽  
Corina Rusu ◽  
Monica Lupsor-Platon ◽  
Oana Nicoara Farcau ◽  
Petra Fischer ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
General Electric ◽  
Clinically Significant

Abstract Purpose Clinically significant portal hypertension (CSPH) is responsible for most of the complications in patients with cirrhosis. Liver stiffness (LS) measurement by vibration-controlled transient elastography (VCTE) is currently used to evaluate CSPH. Bi-dimensional shear wave elastography from General Electric (2D-SWE.GE) has not yet been validated for the diagnosis of PHT. Our aims were to test whether 2D-SWE.GE-LS is able to evaluate CSPH, to determine the reliability criteria of the method and to compare its accuracy with that of VCTE-LS in this clinical setting. Materials and Methods Patients with chronic liver disease referred to hepatic catheterization (HVPG) were consecutively enrolled. HVPG and LS by both VCTE and 2D-SWE.GE were performed on the same day. The diagnostic performance of each LS method was compared against HVPG and between each other. Results 2D-SWE.GE-LS was possible in 123/127 (96.90 %) patients. The ability to record at least 5 LS measurements by 2D-SWE.GE and IQR < 30 % were the only features associated with reliable results. 2D-SWE.GE-LS was highly correlated with HVPG (r = 0.704; p < 0.0001), especially if HVPG < 10 mmHg and was significantly higher in patients with CSPH (15.52 vs. 8.14 kPa; p < 0.0001). For a cut-off value of 11.3 kPa, the AUROC of 2D-SWE.GE-LS to detect CSPH was 0.91, which was not inferior to VCTE-LS (0.92; p = 0.79). The diagnostic accuracy of LS by 2D-SWE.GE-LS to detect CSPH was similar with the one of VCTE-LS (83.74 % vs. 85.37 %; p = 0.238). The diagnostic accuracy was not enhanced by using different cut-off values which enhanced the sensitivity or the specificity. However, in the subgroup of compensated patients with alcoholic liver disease, 2D-SWE.GE-LS classified CSPH better than VCTE-LS (93.33 % vs. 85.71 %, p = 0.039). Conclusion 2D-SWE.GE-LS has good accuracy, not inferior to VCTE-LS, for the diagnosis of CSPH.

scholarly journals Sequential shear-wave elastography of liver and spleen rules out clinically significant portal hypertension in compensated advanced chronic liver disease

Gut ◽  
2016 ◽  
Vol 66 (3) ◽  
pp. 558-559 ◽  
Author(s):  
Christian Jansen ◽  
Christopher Bogs ◽  
Aleksander Krag ◽  
Sven Francque ◽  
Jonel Trebicka
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
Clinically Significant

Indocyanine Green as a Predictor of Clinically Significant Portal Hypertension in a Prospective Cohort Study of Patients With Chronic Liver Disease

2011 ◽  
Vol 140 (5) ◽  
pp. S-902
Author(s):  
Andrea Lisotti ◽  
Francesco Azzaroli ◽  
Laura Turco ◽  
Federica Buonfiglioli ◽  
Paolo Cecinato ◽  
...  
Keyword(s):  
Cohort Study ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Indocyanine Green ◽  
Chronic Liver Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Chronic Liver ◽  
Clinically Significant

Clinically significant portal hypertension in chronic liver disease: Always cirrhosis?

2018 ◽  
Vol 68 ◽  
pp. S734
Author(s):  
S. Rodrigues ◽  
A. Berzigotti ◽  
M. Montani ◽  
A. De Gottardi ◽  
J. Bosch
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Clinically Significant
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