O78 PROSPECTIVE COMPARISON OF LIVER AND SPLEEN STIFFNESS AND COMPOSITE SCORES, USING SUPERSONIC-SHEAR-IMAGING OR TRANSIENT ELASTOGRAPHY, FOR DETECTING CLINICALLY SIGNIFICANT PORTAL HYPERTENSION IN PATIENTS WITH CIRRHOSIS

2014 ◽  
Vol 60 (1) ◽  
pp. S32
Author(s):  
L. Elkrief ◽  
P.-E. Rautou ◽  
M. Ronot ◽  
S. Lambert ◽  
M. Dioguardi Burgio ◽  
...  
2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Mindaugas Marozas ◽  
Romanas Zykus ◽  
Andrius Sakalauskas ◽  
Limas Kupčinskas ◽  
Arūnas Lukoševičius

Portal hypertension (PHT) is a key event in the evolution of different chronic liver diseases and leads to the morbidity and mortality of patients. The traditional reliable PHT evaluation method is a hepatic venous pressure gradient (HVPG) measurement, which is invasive and not always available or acceptable to patients. The HVPG measurement is relatively expensive and depends on the experience of the physician. There are many potential noninvasive methods to predict PHT, of which liver transient elastography is determined to be the most accurate; however, even transient elastography lacks the accuracy to be a perfect noninvasive diagnostic method of PHT. In this research, we are focusing on noninvasive PHT assessment methods that rely on selected best-supervised learning algorithms which use a wide set of noninvasively obtained data, including demographical, clinical, laboratory, instrumental, and transient elastography measurements. In order to build the best performing classification meta-algorithm, a set of 21 classification algorithms have been tested. The problem was expanded by selecting the best performing clinical attributes using algorithm-specific filtering methods that give the lowest error rate to predict clinically significant PHT. The suggested meta-algorithm objectively outperforms other methods found in literature and can be a good substitute for invasive PHT evaluation methods.


2020 ◽  
pp. 1-2
Author(s):  
Revathy Marimuthu Shanmugam ◽  
Vinay C ◽  
Sathya Gopalasamy ◽  
Chitra Shanmugam

BACKGROUND: Many noninvasive surrogate marker for Portal hypertension or for the presence or grade of esophageal varices were studied..Splenomegaly along with splenic congestion secondary to splenic hyperdynamic circulation is seen secondary to Portal hypertension in cirrhotic patients that can be quantified by elastography. AIM:The aim of this study was to investigate whether spleen stiffness, assessed by TE, useful tool for grading chronic liver diseases and to compare its performance in predicting the presence and size of esophageal varices in liver cirrhosis patients. METHODOLOGY:86 patients with cirrhosis and 80 controls underwent transient elastography of liver and spleen for the assessment of liver stiffness (LSM) and spleen stiffness (SSM) . Upper GI endoscopy done in all Cirrhotic patients. RESULTS: Spleen stiffness showed higher values in liver cirrhosis patients as compared with controls: 58.2 kpa vs14.8 kpa (P < 0.0001) and also found to be significantly higher in cirrhotic patients compared with varices and those without varices (69.01 vs 42.05 kpa, P < 0.0001). Liver stiffness was also found to be higher in cirrhotic patients with varices when compared to patients without varices (38.5vs 21.2 kpa). Using both liver and spleen stiffness measurement we can predicted the presence of esophageal varices correctly. CONCLUSION: Spleen stiffness can be assessed using transient elastography, higher value correlated well with liver cirrhosis and presence of esophageal varices although it couldn’t correlate with grade of Esophageal Varix. Combined assessment of spleen and liver stiffness had better prediction of presence of Esophageal Varix.


Author(s):  
Francesca Saffioti ◽  
Davide Roccarina ◽  
Matteo Rosselli ◽  
Roberta Stupia ◽  
Aileen Marshall ◽  
...  

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bubu A. Banini ◽  
Samarth Patel ◽  
Jonathan W. Yu ◽  
Le Kang ◽  
Christopher Bailey ◽  
...  

2011 ◽  
Vol 31 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Maria Poca ◽  
Angela Puente ◽  
Isabel Graupera ◽  
Càndid Villanueva

Prognostic markers of compensated cirrhosis should mainly investigate factors involved with progression to decompensation because death in cirrhosis is related with decompensation. Portal hypertension plays a crucial role in the pathophysiology of most complications of cirrhosis. Accordingly, HVPGmonitoring has strong prognostic value. An HVPG ≥ 10 mmHg determines a significantly higher risk of developing decompensation. Esophageal varices also can develop when the HVPG is ≥ 10 mmHg, although an HVPG ≥ 12 mmHg is required for variceal bleeding to occur. Monitoring the changes induced by the treatment of portal hypertension on HVPG, provides strong prognostic information. In compensated cirrhosis hemodynamic response is appropriate when the HVPG decreased to <10 mmHg or by > 10% from baseline, because the incidence of complications such as bleeding or ascites significantly decrease when these targets are achieved. Whether serum markers, such as the FibroTest, they, may be valuable to predict decompensation should be established. Transient Elastography is a promising technique that has shown an excellent accuracy to detect severe portal hypertension. However, whether it can adequately determine clinically significant portal hypertension, and risk of developing varices and decompensation, should be established. Magnetic Resonance Elastography is also promising.


2018 ◽  
Vol 67 (4) ◽  
pp. 446-451 ◽  
Author(s):  
Harry Sutton ◽  
Emer Fitzpatrick ◽  
Mark Davenport ◽  
Charlotte Burford ◽  
Emma Alexander ◽  
...  

2020 ◽  
Vol 158 (6) ◽  
pp. S-1385
Author(s):  
Guillermo A. Ortiz ◽  
Chiara Palumbo ◽  
Mubarak W. Sayyar ◽  
Maya Balakrishnan ◽  
Arpan Mohanty ◽  
...  

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