Value of spleen stiffness measured by noninvasive method in evaluating the severity of cirrhotic portal hypertension
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摘要: 肝硬化门静脉高压可导致食管静脉曲张破裂出血等严重并发症。门静脉压力梯度(HVPG)及上消化道内镜可用于评估门静脉高压,预测出血风险,但二者的有创性限制了其临床应用,因而通过无创检查手段评估门静脉高压在临床上具有一定优势。介绍了采用瞬时弹性成像技术、声脉冲辐射力成像技术、实时组织弹性成像及磁共振弹性成像等无创技术测定脾脏硬度值的方法及其对门静脉高压的评估作用和影响因素,指出各检测手段测定的脾脏硬度对食管静脉曲张程度及门静脉压力的诊断效能的差异尚未能统一,需进一步研究。Abstract: Cirrhotic portal hypertension can lead to serious complications including esophageal variceal bleeding. Hepatic venous pressure gradient( HVPG) and upper gastrointestinal endoscopy can be used to evaluate the severity of portal hypertension and predict the risk of bleeding. However,both methods are invasive,which limits their clinical practice. Therefore,noninvasive techniques for the evaluation of portal hypertension will have certain advantages in clinical practice. This article introduces the noninvasive methods for the measurement of spleen stiffness,including transient elastography,acoustic radiation force impulse,real- time tissue elastography,and magnetic resonance elastography,as well as the value of these methods in evaluation of portal hypertension and influencing factors. It is pointed out that the difference in the diagnostic efficiency of spleen stiffness measured by these methods in portal hypertension needs to be verified by further studies.
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Key words:
- liver cirrhosis /
- hypertension /
- portal /
- spleen stiffness
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