title: Shear-wave elastography: a noninvasive tool for monitoring changing hepatic venous pressure gradients in patients with cirrhosis.
abstract: OBJECTIVE
  To investigate whether liver stiffness ( LS liver stiffness ) and change in LS liver stiffness measurements ( ΔLS change in LS ) at shear-wave elastography ( SWE shear-wave elastography ) correlates with the hepatic venous pressure gradient ( HVPG hepatic venous pressure gradient ) and to assess the feasibility of using SWE shear-wave elastography to estimate the change in HVPG hepatic venous pressure gradient ( ΔHVPG change in HVPG ) in patients with portal hypertension.
  
  
  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 hepatic venous pressure gradient measurement were included. Among these patients, 23 who underwent follow-up HVPG hepatic venous pressure gradient measurement to evaluate response to treatment were included in the follow-up group. The correlation between HVPG hepatic venous pressure gradient and LS liver stiffness was analyzed by using the Pearson correlation test. In the follow-up group, whether ΔHVPG change in HVPG was correlated with ΔLS change in LS was also evaluated. Thereafter, the areas under the receiver operating characteristic curves ( AUC area under the ROC curve s) were calculated to determine the diagnostic performances of ΔLS change in LS and the second LS liver stiffness measurement after medical treatment and to compare their performances in association with clinical improvement and aggravation of portal hypertension.
  
  
  RESULTS
  LS liver stiffness was moderately correlated with HVPG hepatic venous pressure gradient (r = 0.593) in the single-measurement group. There was also a strong correlation between ΔLS change in LS and ΔHVPG change in HVPG (r = 0.863). At comparison of the second LS liver stiffness measurement, ΔLS change in LS showed no significant difference in AUC area under the ROC curve in patients with improvement (0.627 vs 0.794, P = .201) but showed higher AUC area under the ROC curve in association with aggravation of portal hypertension (0.925 vs 0.611, P = .026).
  
  
  CONCLUSIONS
  Estimating ΔHVPG change in HVPG by using SWE shear-wave elastography may be useful in patients with cirrhosis and portal hypertension.
authors.affiliation: From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea (S.Y.C., W.K.J.); and Departments of Radiology (Y.K., J.K.) and Internal Medicine (T.Y.K., J.H.S.), Hanyang University College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea.
authors.forename: Seo-Youn
authors.initials: SY
authors.lastname: Choi
authors.forename: Woo Kyoung
authors.initials: WK
authors.lastname: Jeong
authors.forename: Yongsoo
authors.initials: Y
authors.lastname: Kim
authors.forename: Jinoo
authors.initials: J
authors.lastname: Kim
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed