Elastography methods for the non-invasive assessment of portal hypertension
- 12 September 2017
- journal article
- review article
- Published by Taylor & Francis in Expert Review of Gastroenterology & Hepatology
- Vol. 12 (2), 155-164
- https://doi.org/10.1080/17474124.2017.1374852
Abstract
Introduction: The gold standard to assess the presence and severity of portal hypertension remains the hepatic vein pressure gradient, however the recent development of non-invasive assessment using elastography techniques offers valuable alternatives. In this review, we discuss the diagnostic accuracy and utility of such techniques in patients with portal hypertension due to cirrhosis. Areas covered: A literature search focused on liver and spleen stiffness measurement with different elastographic techniques for the assessment of the presence and severity of portal hypertension and oesophageal varices in people with chronic liver disease. The combination of elastography with parameters such as platelet count and spleen size is also discussed. Expert commentary: Non-invasive assessment of liver fibrosis and portal hypertension is a validated tool for the diagnosis and follow-up of patients. Baveno VI recommended the combination of transient elastography and platelet count for ruling out varices needing treatment in patients with compensated advanced chronic liver disease. Assessment of aetiology specific cut-offs for ruling in and ruling out clinically significant portal hypertension is an unmet clinical need. The incorporation of spleen stiffness measurements in non-invasive algorithms using validated software and improved measuring scales might enhance the non-invasive diagnosis of portal hypertension in the next 5 years.Keywords
This publication has 86 references indexed in Scilit:
- Measurement of Spleen Stiffness by Acoustic Radiation Force Impulse Imaging Identifies Cirrhotic Patients With Esophageal VaricesGastroenterology, 2013
- Transient elastography and simple blood markers in the diagnosis of esophageal varices for compensated patients with hepatitis B virus‐related cirrhosisJournal of Gastroenterology and Hepatology, 2012
- Non-selective β-blockers improve the correlation of liver stiffness and portal pressure in advanced cirrhosisThe Esophagus, 2011
- Spleen stiffness measurement using fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patientsJournal of Gastroenterology and Hepatology, 2010
- Noninvasive Diagnosis of Large Esophageal Varices by Fibroscan: Strong Influence of the Cirrhosis EtiologyAlcohol, Clinical and Experimental Research, 2010
- Usefulness of liver stiffness measurement for predicting the presence of esophageal varices in patients with liver cirrhosisThe Korean Journal of Hepatology, 2008
- Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varicesJournal of Hepatology, 2006
- Prediction of the First Variceal Hemorrhage in Patients with Cirrhosis of the Liver and Esophageal VaricesNew England Journal of Medicine, 1988
- Reduction of the increased portal vascular resistance of the isolated perfused cirrhotic rat liver by vasodilatorsJournal of Hepatology, 1985
- Prediction of variceal hemorrhage by esophageal endoscopyGastrointestinal Endoscopy, 1981