Measurement of hepatic venous pressure gradient is a standard method for the assessment of portal pressure.
It correlates with the occurrence of its complications.
Liver stiffness measurement has been proposed as a noninvasive technique for the prediction of the complications of cirrhosis.
|Liver stiffness measurement cutoff values of 14 kPa had a sensitivity of 97%|
Dr Massimo Pinzani and colleagues from Italy evaluated the ability of liver stiffness measurement vs hepatic venous pressure gradient to to predict severe portal hypertension.
The research team assessed 61 consecutive patients with Hepatitis C virus-related chronic liver disease.
The researchers found a strong relationship between liver stiffness measurement and hepatic venous pressure gradient measurements in the overall population.
The correlation was excellent for hepatic venous pressure gradient values less than 10 or 12 mm Hg.
However, the team noted that linear regression analysis was not optimal for hepatic venous pressure gradient values 10 mm Hg or 12 mm Hg.
The area under the receiver of operator curve for the prediction of hepatic venous pressure gradient for 10 and 12 mm Hg were 0.99 and 0.92, respectively.
The team noted that at liver stiffness measurement cutoff values of 14 kPa and 18 kPa, sensitivity was 97% and 94%, respectively.
The researchers observed that in patients with cirrhosis, liver stiffness measurement positively correlated with the presence of esophageal varices.
The team detected no correlation between liver stiffness measurement and esophageal varices size.
The area under the receiver of operator curve for the prediction of esophageal varices was 0.8.
The researchers found that for esophageal varices, a cutoff value of 18 kPa had a 90% sensitivity.
Dr Pinzani's team concluded, "Liver stiffness measurement represents a non-invasive tool for the identification of chronic liver disease patients with clinically significant or severe portal hypertension."
"It could be employed for screening patients to be subjected to standard investigations including upper gastrointestinal endoscopy and hemodynamic studies."