Shear-Wave Elastography: A Noninvasive Tool for Monitoring Changing Hepatic Venous Pressure Gradients in Patients with Cirrhosis

초록

Purpose: To investigate whether liver stiffness (LS) and change in LS measurements (Delta LS) at shear-wave elastography (SWE) correlates with the hepatic venous pressure gradient (HVPG) and to assess the feasibility of using SWE to estimate the change in HVPG (Delta HVPG) in patients with portal hypertension. Materials and Methods: Institutional review board approval was obtained, with waiver of informed consent. Between September 2010 and October 2012, 97 consecutive patients who were given a diagnosis of portal hypertension on the basis of HVPG measurement were included. Among these patients, 23 who underwent follow-up HVPG measurement to evaluate response to treatment were included in the follow-up group. The correlation between HVPG and LS was analyzed by using the Pearson correlation test. In the follow-up group, whether Delta HVPG was correlated with Delta LS was also evaluated. Thereafter, the areas under the receiver operating characteristic curves (AUCs) were calculated to determine the diagnostic performances of Delta LS and the second LS measurement after medical treatment and to compare their performances in association with clinical improvement and aggravation of portal hypertension. Results: LS was moderately correlated with HVPG (r = 0.593) in the single-measurement group. There was also a strong correlation between Delta LS and Delta HVPG (r = 0.863). At comparison of the second LS measurement, Delta LS showed no significant difference in AUC in patients with improvement (0.627 vs 0.794, P = .201) but showed higher AUC in association with aggravation of portal hypertension (0.925 vs 0.611, P = .026). Conclusion: Estimating Delta HVPG by using SWE may be useful in patients with cirrhosis and portal hypertension.

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