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Elastography methods for the non-invasive assessment of portal hypertension

Roccarina, D; Rosselli, M; Genesca, J; Tsochatzis, EA; (2018) Elastography methods for the non-invasive assessment of portal hypertension. Expert Review of Gastroenterology & Hepatology , 12 (2) pp. 155-164. 10.1080/17474124.2017.1374852. Green open access

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Abstract

INTRODUCTION: The gold standard to assess the presence and severity of portal hypertension remains the hepatic vein pressure gradient, however the recent development of non-invasive assessment using elastography techniques offers valuable alternatives. In this review, we discuss the diagnostic accuracy and utility of such techniques in patients with portal hypertension due to cirrhosis. AREAS COVERED: A literature search focused on liver and spleen stiffness measurement with different elastographic techniques for the assessment of the presence and severity of portal hypertension and oesophageal varices in people with chronic liver disease. The combination of elastography with parameters such as platelet count and spleen size is also discussed. EXPERT COMMENTARY: Non-invasive assessment of liver fibrosis and portal hypertension is a validated tool for the diagnosis and follow-up of patients. Baveno VI recommended the combination of transient elastography and platelet count for ruling out varices needing treatment in patients with compensated advanced chronic liver disease. Assessment of aetiology specific cut-offs for ruling in and ruling out clinically significant portal hypertension is an unmet clinical need. The incorporation of spleen stiffness measurements in non-invasive algorithms using validated software and improved measuring scales might enhance the non-invasive diagnosis of portal hypertension in the next five years.

Type: Article
Title: Elastography methods for the non-invasive assessment of portal hypertension
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/17474124.2017.1374852
Publisher version: http://dx.doi.org/10.1080/17474124.2017.1374852
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: ARFI, Baveno, Fibroscan, HVPG, Spleen stiffness, Varices
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/1572471
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