Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease
Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease
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DOI：
10.1111/j.1365-2036.2008.03701.x
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发表时间：
2008-06-15
影响因子：
7.6
通讯作者：
Vinel, J. P.
中科院分区：
文献类型：
--
作者：
Bureau, C.;Metivier, S.;Vinel, J. P.
背景肝静脉压力梯度（HVPG）是肝硬化患者的一个预后指标。瞬时弹性成像测量肝脏硬度（LS）。目的评估LS和HVPG之间的相关性，并探讨瞬时弹性成像诊断显著门脉高压症（PHT）的性能。方法采用Fibroscan测量150例连续患者的肝脏硬度，这些患者接受了肝活检和血流动力学测量。收集患者的临床和生物学资料。结果肝静脉压差≥ 10 mmHg者76例，平均10 mmHg。89例患者诊断为肝硬化。HVPG与LS相关（rho = 0.858; P < 0.001），与凝血酶原指数呈负相关（rho = -0.718; P < 0.001）。关于显著PHT，LS和凝血酶原指数的AUROC分别为0.945 [0.904-0.987]和0.892 [0.837-0.947]。21 kPa的截止值准确预测显着PHT在92%的144例LS是successful.Conclusion肝硬度测量与HVPG和瞬态弹性成像识别显着PHT的患者。
Background Hepatic venous pressure gradient (HVPG) is a prognostic marker in patients with cirrhosis. Transient elastography measures liver stiffness (LS).Aim To assess the correlation between LS and HVPG and to investigate the performance of transient elastography for the diagnosis of significant portal hypertension (PHT).Methods Liver stiffness was measured by Fibroscan in 150 consecutive patients who underwent a liver biopsy with haemodynamic measurements. Usual clinical and biological data were collected. Significant PHT was defined as a HVPG >= 10 mmHg.Results Hepatic venous pressure gradient was found to be >= 10 mmHg in 76 patients. Cirrhosis was diagnosed in 89 patients. HVPG was found to be correlated with: LS (rho = 0.858; P < 0.001) and inversely correlated with prothrombin index (rho = -0.718; P < 0.001). Regarding significant PHT, AUROC for LS and prothrombin index were 0.945 [0.904-0.987] and 0.892 [0.837-0.947] respectively. The cut-off value of 21 kPa accurately predicted significant PHT in 92% of the 144 patients for whom LS was successful.Conclusion Liver stiffness measurement is correlated with HVPG and transient elastography identifies patients with significant PHT.