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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 11
Nov.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(11): 2488-2492

Value of liver stiffness measured by acoustic radiation force impulse in diagnosis of cirrhotic portal hypertension

DOI: 10.3969/j.issn.1001-5256.2022.11.010
  • 1.

    Medical College of Southeast University, Nanjing 210000, China

  • 2a.

    Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210000, China

  • 2b.

    Department of Ultrasonic Diagnosis, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210000, China

Research funding:

National Natural Science Foundation of China (81900552)

More Information
  • Corresponding author: ZHANG Feng, fzdndx@126.com(ORCID: 0000-0002-3653-5977); ZHUGE Yuzheng, yuzheng9111963@aliyun.com (ORCID: 0000-0002-3829-5831)
  • Received Date: 2022-04-07
  • Accepted Date: 2022-05-16
  • Published Date: 2022-11-20
    Abstract
  •   Objective  To investigate the accuracy of liver stiffness (LS) as a noninvasive index in predicting hepatic venous pressure gradient (HVPG) in patients with decompensated liver cirrhosis and the value of LS in the diagnosis of decompensated liver cirrhosis.  Methods  A retrospective analysis was performed for the clinical data of 88 patients with decompensated cirrhosis due to viral hepatitis or decompensated alcoholic cirrhosis who received both HVPG measurement and LS measurement by acoustic radiation force impulse (ARFI) in Department of Gastroenterology, Nanjing Drum Tower Hospital, from April 2013 to June 2021, and according to HVPG, the patients were divided into serious portal hypertension (SPH) (HVPG≥20 mmHg) group with 24 patients and non-SPH (HVPG < 20 mmHg) group with 64 patients. The two groups were compared in terms of LS, spleen stiffness, portal vein velocity, and related biochemical parameters. The t-test or the Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A Pearson correlation analysis was used to investigate the correlation of different noninvasive indices with HVPG, and a Logistic regression analysis was used to investigate the association of different noninvasive indices with the risk of SPH. Receiver operating characteristic (ROC) curves were plotted for different noninvasive indices in predicting HVPG≥20 mmHg, and the area under the ROC curve (AUC), sensitivity, specificity, maximum Youden index, and corresponding cut-off value were calculated to investigate the value of each index in predicting SPH.  Results  Among the 88 patients, 76 had decompensated cirrhosis due to viral hepatitis and 12 had decompensated alcoholic cirrhosis. There were no significant differences between the SPH group and the non-SPH group in age, sex, white blood cell count, hemoglobin, platelet count, prothrombin time, alanine aminotransferase, aspartate aminotransferase, albumin, serum sodium, creatinine, Child-Pugh class, and spleen stiffness, while there was a significant difference in LS between the two groups (t=-3.970, P < 0.01). The correlation analysis showed that HVPG was positively correlated with LS (r=0.458, P < 0.001). The Logistic regression analysis showed that LS was a risk factor for SPH (odds ratio=3.941, 95% confidence interval: 1.245-12.476, P=0.020). The ROC curve analysis showed that LS had an AUC of 0.751 in predicting the onset of SPH, with a sensitivity of 54.17% and a specificity of 90.63% at the optimal cut-off value of 2.295 m/s.  Conclusion  In patients with decompensated cirrhosis, LS measured by ARFI is correlated with HVPG and has a certain value in the non-invasive diagnosis of decompensated cirrhosis with HVPG≥20 mmHg.

     

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    • References(19)
  • [1]
    IWAKIRI Y, TREBICKA J. Portal hypertension in cirrhosis: Pathophysiological mechanisms and therapy[J]. JHEP Rep, 2021, 3(4): 100316. DOI: 10.1016/j.jhepr.2021.100316.
    [2]
    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.
    [3]
    GARCIA-TSAO G, ABRALDES JG, BERZIGOTTI A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases[J]. Hepatology, 2017, 65(1): 310-335. DOI: 10.1002/hep.28906.
    [4]
    LEE E, KIM YJ, GOO DE, et al. Comparison of hepatic venous pressure gradient and endoscopic grading of esophageal varices[J]. World J Gastroenterol, 2016, 22(11): 3212-3219. DOI: 10.3748/wjg.v22.i11.3212.
    [5]
    ELKRIEF L, RONOT M, ANDRADE F, et al. Non-invasive evaluation of portal hypertension using shear-wave elastography: analysis of two algorithms combining liver and spleen stiffness in 191 patients with cirrhosis[J]. Aliment Pharmacol Ther, 2018, 47(5): 621-630. DOI: 10.1111/apt.14488.
    [6]
    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.
    [7]
    KIM TY, JEONG WK, SOHN JH, et al. Evaluation of portal hypertension by real-time shear wave elastography in cirrhotic patients[J]. Liver Int, 2015, 35(11): 2416-2424. DOI: 10.1111/liv.12846.
    [8]
    FLEMING KM, AITHAL GP, CARD TR, et al. The rate of decompensation and clinical progression of disease in people with cirrhosis: a cohort study[J]. Aliment Pharmacol Ther, 2010, 32(11-12): 1343-1350. DOI: 10.1111/j.1365-2036.2010.04473.x.
    [9]
    LURIE Y, WEBB M, CYTTER-KUINT R, et al. Non-invasive diagnosis of liver fibrosis and cirrhosis[J]. World J Gastroenterol, 2015, 21(41): 11567-11583. DOI: 10.3748/wjg.v21.i41.11567.
    [10]
    KENNEDY P, WAGNER M, CASTÉRA L, et al. Quantitative elastography methods in liver disease: current evidence and future directions[J]. Radiology, 2018, 286(3): 738-763. DOI: 10.1148/radiol.2018170601.
    [11]
    CORPECHOT C, GAOUAR F, EL NAGGAR A, et al. Baseline values and changes in liver stiffness measured by transient elastography are associated with severity of fibrosis and outcomes of patients with primary sclerosing cholangitis[J]. Gastroenterology, 2014, 146(4): 970-979. DOI: 10.1053/j.gastro.2013.12.030.
    [12]
    SINGH S, FUJⅡ LL, MURAD MH, et al. Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2013, 11(12): 1573-1584. DOI: 10.1016/j.cgh.2013.07.034.
    [13]
    BERZIGOTTI A, SEIJO S, ARENA U, et al. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis[J]. Gastroenterology, 2013, 144(1): 102-111. DOI: 10.1053/j.gastro.2012.10.001.
    [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]
    XIE Q, LI Z, TANG Z, et al. Value of liver/spleen stiffness combined with serum adenosine deaminase in predicting severe esophageal varices in patients with hepatitis B cirrhosis[J]. J Clin Hepatol, 2021, 37(6): 1314-1318. DOI: 10.3969/j.issn.1001-5256.2021.06.020.

    谢青, 李曾, 唐臻, 等. 肝脾硬度联合血清腺苷脱氨酶对乙型肝炎肝硬化重度食管静脉曲张的预测价值分析[J]. 临床肝胆病杂志, 2021, 37(6): 1314-1318. DOI: 10.3969/j.issn.1001-5256.2021.06.020.
    [16]
    COSGROVE D, PISCAGLIA F, BAMBER J, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications[J]. Ultraschall Med, 2013, 34(3): 238-253. DOI: 10.1055/s-0033-1335375.
    [17]
    D'ONOFRIO M, CROSARA S, de ROBERTIS R, et al. Acoustic radiation force impulse of the liver[J]. World J Gastroenterol, 2013, 19(30): 4841-4849. DOI: 10.3748/wjg.v19.i30.4841.
    [18]
    GARCIA-TSAO G, ABRALDES JG, BERZIGOTTI A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases[J]. Hepatology, 2017, 65(1): 310-335. DOI: 10.1002/hep.28906.
    [19]
    MIAO CC, ZHUGE YZ, ZHANG M, et al. Correlation analysis between liver and spleen stiffness measured by acoustic radiation force impulse and hepatic venous pressure gradient[J]. Chin J Dig, 2017, 37(1): 30-34. DOI: 10.3760/cma.j.issn.0254-1432.2017.01.009.

    缪成成, 诸葛宇征, 张明, 等. 声脉冲辐射力成像测量的肝脏和脾脏硬度与肝静脉压力梯度的相关性分析[J]. 中华消化杂志, 2017, 37(1): 30-34. DOI: 10.3760/cma.j.issn.0254-1432.2017.01.009.
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