title: Combined measurements of serum bile acid level and splenic volume may be useful to noninvasively assess portal venous pressure.
abstract: BACKGROUND
  We aimed to identify a noninvasive predictor of portal venous pressure (PVP).
  
  
  METHODS
  We directly measured the PVP in 40 consecutive patients who underwent direct percutaneous transhepatic portal vein puncture as part of the therapeutic management for liver diseases, and we evaluated the association of the PVP with noninvasive clinical parameters. The backgrounds of the liver were normal in 13 patients, chronic hepatitis in 17, and liver cirrhosis in ten.
  
  
  RESULTS
  The mean PVP was 202 ± 114 mmH(2)O. In a multivariate linear regression analysis, the serum bile acid level and splenic volume showed independent positive correlations with the PVP (P < 0.001 and 0.002, respectively). The formula for estimating PVP was identified as follows: PVP (mmH(2)O) = serum bile acid (μmol/L) × 2.593 + splenic volume (cm(3)) × 0.416 + 65.929 (R(2) = 0.698). In a receiver operating characteristic (ROC) analysis, the AUC values of serum bile acid and splenic volume at a PVP of 200 mmH(2)O were 0.909 and 0.758, respectively. However, the AUC values of serum bile acid and splenic volume at a PVP of 250 mmH(2)O were 0.792 and 0.926, respectively, suggesting that the serum bile acid level and splenic volume are sensitive predictors of early and advanced portal hypertension, respectively.
  
  
  CONCLUSIONS
  Combined measurements of the serum bile acid level and splenic volume may be useful to noninvasively assess the PVP prior to further invasive procedures.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.forename: Koichi
authors.initials: K
authors.lastname: Doi
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001647:Bile Acids and Salts / Q000097:blood*; D006505:Hepatitis / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications; D008642:Mesenteric Veins; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology*; D013154:Spleen / Q000473:pathology*; D013162:Splenic Vein
chemical_list: D001647:Bile Acids and Salts