Open AccessNon-invasive diagnosis of portal hypertension in cirrhosis using ultrasound based elastography
Author(s) -
Ivica Grgurević,
Tomislav Bokun,
Tonći Božin,
Vladimir Matić,
Sara Haberle,
Ioan Sporea
Publication year - 2017
Publication title -
medical ultrasonography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.473
H-Index - 28
eISSN - 2066-8643
pISSN - 1844-4172
DOI - 10.11152/mu-1019
Subject(s) - medicine , transient elastography , portal hypertension , elastography , cirrhosis , varices , ultrasound , radiology , liver disease , chronic liver disease , ultrasound elastography , liver fibrosis
Liver stiffness measurement (LSM) by ultrasound-based elastography may be used to non-invasively discriminate between the stages of liver fibrosis, rule out cirrhosis and follow its evolution, including the prediction of the presence of oesophageal varices. The same is possible in order to diagnose clinically significant portal hypertension, referring primarilyto transient elastography and LSM values ≥20-25 kPa. The same approach may be used to reliably rule out the presence ofoesophageal varices (LSM 150x109/L). These recommendations refer primarily to patients with viral aetiology of chronic liver disease (hepatitis C), while additional studies are required for other aetiologies. While spleen stiffness measurement (SSM) also poses a logical choice in this indication, controversial results have nevertheless been published on this issue. It should be emphasized, however, that more recent data indicate that this parameter should be included in the diagnostic algorithm for portal hypertension, if not as the sole then as a part of a sequential algorithm, combined with LSM. Until now, transient elastography has been most extensively studied and founded on scientific evidence, although the results of other ultrasound-based elastography techniques demonstrate the same trend for the non-invasive assessment of portal hypertension.