Noninvasive screening and management of cirrhotic portal hypertension

Xiaofeng ZHANG; Jinjun CHEN

doi:10.3969/j.issn.1001-5256.2022.06.002

Volume 38 Issue 6

Jun. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2022 > 38(6): 1220-1223

PDF( 1854 KB)

Noninvasive screening and management of cirrhotic portal hypertension

DOI: 10.3969/j.issn.1001-5256.2022.06.002

Xiaofeng ZHANG^{1, 2},
Jinjun CHEN^{1, 2, 3
,
,
,}

1.
Hepatology Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
2.
Department of Hepatology, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511300, China
3.
Hepatology Institute of Guangdong Province, Guangzhou 510515, China

More Information

Corresponding author: CHEN Jinjun, chjj@smu.edu.cn (ORCID: 0000-0003-4275-9149)
Received Date: 2022-03-06
Accepted Date: 2022-04-12
Published Date: 2022-06-20

Abstract

Abstract

Portal hypertension-related complications are the major cause of death in patients with advanced chronic liver disease (ACLD). Hepatic venous pressure gradient is the golden standard for assessing portal hypertension, and upper gastrointestinal endoscopy is an important method for screening and assessing esophageal and gastric varices and its severity; both methods are invasive and inappropriate for portal hypertension screening and monitoring. Noninvasive approaches, such as transient elastography, acoustic radiation force impulse, and shear wave elastography, have been used for the evaluation of portal hypertension in ACLD patients, especially the screening, stratified diagnosis, and monitoring of clinically significant portal hypertension.
- Liver Cirrhosis,
- Hypertension, Portal,
- Elasticity Imaging Techniques

FullText(HTML)

References(35)

References

[1]	de FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno Ⅶ-Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76(4): 959-974. DOI: 10.1016/j.jhep.2021.12.022.
[2]	D'AMICO G, PASTA L, MORABITO A, et al. Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients[J]. Aliment Pharmacol Ther, 2014, 39(10): 1180-1193. DOI: 10.1111/apt.12721.
[3]	D'AMICO G, GARCIA-TSAO G, PAGLIARO L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies[J]. J Hepatol, 2006, 44(1): 217-231. DOI: 10.1016/j.jhep.2005.10.013.
[4]	RIPOLL C, GROSZMANN R, GARCIA-TSAO G, et al. Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis[J]. Gastroenterology, 2007, 133(2): 481-488. DOI: 10.1053/j.gastro.2007.05.024.
[5]	de FRANCHIS R, Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno Ⅵ Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015, 63(3): 743-752. DOI: 10.1016/j.jhep.2015.05.022.
[6]	PAPATHEODORIDI M, HIRIART JB, LUPSOR-PLATON M, et al. Refining the Baveno Ⅵ elastography criteria for the definition of compensated advanced chronic liver disease[J]. J Hepatol, 2021, 74(5): 1109-1116. DOI: 10.1016/j.jhep.2020.11.050.
[7]	JI Y, LI J, HE Q, et al. Baveno Ⅵ elastography criteria for ruling in cACLD works well in MAFLD patients[J]. J Hepatol, 2021, 75(5): 1243-1245. DOI: 10.1016/j.jhep.2021.06.003.
[8]	ZHOU YJ, GAO F, LIU WY, et al. Screening for compensated advanced chronic liver disease using refined Baveno Ⅵ elastography cutoffs in Asian patients with nonalcoholic fatty liver disease[J]. Aliment Pharmacol Ther, 2021, 54(4): 470-480. DOI: 10.1111/apt.16487.
[9]	VIZZUTTI F, ARENA U, ROMANELLI RG, et al. Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis[J]. Hepatology, 2007, 45(5): 1290-1297. DOI: 10.1002/hep.21665.
[10]	SHI KQ, FAN YC, PAN ZZ, et al. Transient elastography: a meta-analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease[J]. Liver Int, 2013, 33(1): 62-71. DOI: 10.1111/liv.12003.
[11]	REIBERGER T, FERLITSCH A, PAYER BA, et al. Non-selective β-blockers improve the correlation of liver stiffness and portal pressure in advanced cirrhosis[J]. J Gastroenterol, 2012, 47(5): 561-568. DOI: 10.1007/s00535-011-0517-4.
[12]	PONS M, AUGUSTIN S, SCHEINER B, et al. Noninvasive diagnosis of portal hypertension in patients with compensated advanced chronic liver disease[J]. Am J Gastroenterol, 2021, 116(4): 723-732. DOI: 10.14309/ajg.0000000000000994.
[13]	KIM BK, HAN KH, PARK JY, et al. A liver stiffness measurement-based, noninvasive prediction model for high-risk esophageal varices in B-viral liver cirrhosis[J]. Am J Gastroenterol, 2010, 105(6): 1382-1390. DOI: 10.1038/ajg.2009.750.
[14]	ABRALDES JG, BUREAU C, STEFANESCU H, et al. Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The "Anticipate"study[J]. Hepatology, 2016, 64(6): 2173-2184. DOI: 10.1002/hep.28824.
[15]	STAFYLIDOU M, PASCHOS P, KATSOULA A, et al. Performance of Baveno Ⅵ and expanded Baveno Ⅵ criteria for excluding high-risk varices in patients with chronic liver diseases: a systematic review and Meta-analysis[J]. Clin Gastroenterol Hepatol, 2019, 17(9): 1744-1755. e11. DOI: 10.1016/j.cgh.2019.04.062.
[16]	WANG H, WEN B, CHANG X, et al. Baveno Ⅵ criteria and spleen stiffness measurement rule out high-risk varices in virally suppressed HBV-related cirrhosis[J]. J Hepatol, 2021, 74(3): 584-592. DOI: 10.1016/j.jhep.2020.09.034.
[17]	THABUT D, BUREAU C, LAYESE R, et al. Validation of Baveno Ⅵ criteria for screening and surveillance of esophageal varices in patients with compensated cirrhosis and a sustained response to antiviral therapy[J]. Gastroenterology, 2019, 156(4): 997-1009. e5. DOI: 10.1053/j.gastro.2018.11.053.
[18]	DING NS, NGUYEN T, ISER DM, et al. Liver stiffness plus platelet count can be used to exclude high-risk oesophageal varices[J]. Liver Int, 2016, 36(2): 240-245. DOI: 10.1111/liv.12916.
[19]	STEFANESCU H, GRIGORESCU M, LUPSOR M, et al. Spleen stiffness measurement using Fibroscan for the noninvasive assessment of esophageal varices in liver cirrhosis patients[J]. J Gastroenterol Hepatol, 2011, 26(1): 164-170. DOI: 10.1111/j.1440-1746.2010.06325.x.
[20]	COLECCHIA A, RAVAIOLI F, MARASCO G, et al. A combined model based on spleen stiffness measurement and Baveno Ⅵ criteria to rule out high-risk varices in advanced chronic liver disease[J]. J Hepatol, 2018, 69(2): 308-317. DOI: 10.1016/j.jhep.2018.04.023.
[21]	ROBIC MA, PROCOPET B, MÉTIVIER S, et al. Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study[J]. J Hepatol, 2011, 55(5): 1017-1024. DOI: 10.1016/j.jhep.2011.01.051.
[22]	LEE HW, YIP TC, TSE YK, et al. Hepatic decompensation in cirrhotic patients receiving antiviral therapy for chronic hepatitis B[J]. Clin Gastroenterol Hepatol, 2021, 19(9): 1950-1958. e7. DOI: 10.1016/j.cgh.2020.08.064.
[23]	COLECCHIA A, COLLI A, CASAZZA G, et al. Spleen stiffness measurement can predict clinical complications in compensated HCV-related cirrhosis: a prospective study[J]. J Hepatol, 2014, 60(6): 1158-1164. DOI: 10.1016/j.jhep.2014.02.024.
[24]	SALZL P, REIBERGER T, FERLITSCH M, et al. Evaluation of portal hypertension and varices by acoustic radiation force impulse imaging of the liver compared to transient elastography and AST to platelet ratio index[J]. Ultraschall Med, 2014, 35(6): 528-533. DOI: 10.1055/s-0034-1366506.
[25]	KIM HY, SO YH, KIM W, et al. Non-invasive response prediction in prophylactic carvedilol therapy for cirrhotic patients with esophageal varices[J]. J Hepatol, 2019, 70(3): 412-422. DOI: 10.1016/j.jhep.2018.10.018.
[26]	JANSEN C, BOGS C, VERLINDEN W, et al. Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study[J]. Liver Int, 2017, 37(3): 396-405. DOI: 10.1111/liv.13243.
[27]	ZHU YL, DING H, FU TT, et al. Portal hypertension in hepatitis B-related cirrhosis: Diagnostic accuracy of liver and spleen stiffness by 2-D shear-wave elastography[J]. Hepatol Res, 2019, 49(5): 540-549. DOI: 10.1111/hepr.13306.
[28]	TREBICKA J, GU W, DE LEDINGHEN V, et al. Two-dimensional shear wave elastography predicts survival in advanced chronic liver disease[J]. Gut, 2022, 71(2): 402-414. DOI: 10.1136/gutjnl-2020-323419.
[29]	SINGH S, VENKATESH SK, WANG Z, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data[J]. Clin Gastroenterol Hepatol, 2015, 13(3): 440-451. e6. DOI: 10.1016/j.cgh.2014.09.046.
[30]	HUWART L, SEMPOUX C, SALAMEH N, et al. Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index[J]. Radiology, 2007, 245(2): 458-466. DOI: 10.1148/radiol.2452061673.
[31]	WAGNER M, HECTORS S, BANE O, et al. Noninvasive prediction of portal pressure with MR elastography and DCE-MRI of the liver and spleen: Preliminary results[J]. J Magn Reson Imaging, 2018, 48(4): 1091-1103. DOI: 10.1002/jmri.26026.
[32]	EISENBREY JR, DAVE JK, HALLDORSDOTTIR VG, et al. Chronic liver disease: noninvasive subharmonic aided pressure estimation of hepatic venous pressure gradient[J]. Radiology, 2013, 268(2): 581-588. DOI: 10.1148/radiol.13121769.
[33]	GUPTA I, EISENBREY JR, MACHADO P, et al. Diagnosing portal hypertension with noninvasive subharmonic pressure estimates from a US contrast agent[J]. Radiology, 2021, 298(1): 104-111. DOI: 10.1148/radiol.2020202677.
[34]	SHARMA S, AGARWAL S, GUNJAN D, et al. Deciding among noninvasive tools for predicting varices needing treatment in chronic liver disease: an analysis of Asian cohort[J]. Am J Gastroenterol, 2020, 115(10): 1650-1656. DOI: 10.14309/ajg.0000000000000722.
[35]	CALVARUSO V, CACCIOLA I, LICATA A, et al. Is transient elastography needed for noninvasive assessment of high-risk varices? The REAL experience[J]. Am J Gastroenterol, 2019, 114(8): 1275-1282. DOI: 10.14309/ajg.0000000000000266.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (825) PDF downloads(166)

Noninvasive screening and management of cirrhotic portal hypertension

DOI: 10.3969/j.issn.1001-5256.2022.06.002

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Noninvasive screening and management of cirrhotic portal hypertension

DOI: 10.3969/j.issn.1001-5256.2022.06.002

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content