Clinical value of contrast-enhanced ultrasound in evaluating portal hypertension in patients with decompensated liver cirrhosis
10.3760/cma.j.issn.1007-3418.2016.04.006
- VernacularTitle:超声造影评价失代偿期肝硬化患者门静脉高压的临床价值
- Author:
Yuan ZHUANG
1
;
Hong DING
;
Hong HAN
;
Feng MAO
;
Jianjun LUO
;
Shiyao CHEN
;
Wenping WANG
Author Information
1. 复旦大学附属中山医院超声科
- Keywords:
Liver corrhosis,decompensated;
Portal hypertension;
Ultrasonography;
Transit time;
Hepatic vein pressure gradient
- From:
Chinese Journal of Hepatology
2016;24(4):270-274
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between contrast-enhanced ultrasound parameters and hepatic venous pressure gradient (HVPG),and to develop a new noninvasive method for the evaluation of portal hypertension in patients with decompensated liver cirrhosis.Methods One-hundred patients with decompensated liver cirrhosis were examined by contrast-enhanced ultrasound,and the dynamic images were collected for offline analysis.The contrast arrival time was obtained in the hepatic artery (HA),portal vein (PV),and hepatic vein (HV),and HA-HV transit time (HA-HVTT) and PV-HV transit time (PV-HVTT) were calculated.At the same time,HVPG was measured within 24 hours after contrast-enhanced ultrasound,Pearson correlation analysis was performed between each parameter and HVPG,and the receiver operating characteristic (ROC) curve was also used for analysis.Results HV arrival time (HVAT),HA-HVTT,and PV-HVTT were negatively correlated with HVPG (r =-0.385,-0.409,and-0.572,respectively).The area under the ROC curve (AUROC) was 0.903 for PV-HVTT < 2.5 s in judging HVPG ≥≥ 10 mmHg in patients with decompensated liver cirrhosis,and the sensitivity and specificity were 74.4% and 89.5%,respectively.The AUROC was 0.861 for PV-HVTT < 1.5 s in judging HVPG ≥ 16 mmHg in these patients,and the sensitivity and specificity were 80.4% and 81.5%,respectively.Conclusions HVAT and intrahepatic transit time demonstrate negative linear correlations with HVPG in patients with decompensated liver cirrhosis,and among all parameters,PV-HVTT shows the strongest correlation with HVPG and can be used to determine and predict the severity of portal hypertension.