title: Evaluation of portal hypertension by real-time shear wave elastography in cirrhotic patients.
abstract: OBJECTIVE
  To assess the correlation between liver stiffness measurement (LSM) by real-time shear wave elastography (SWE) and hepatic venous pressure gradient (HVPG) and to investigate the diagnostic performance of SWE for predicting clinically significant and severe portal hypertension (CSPH and SPH).
  
  
  METHODS
  Clinical data of 115 cirrhotic patients with haemodynamic measurement were consecutively collected. Liver stiffness (LS) was measured using SWE by repeated performance five times per patient, and the median value and interquartile range of the parameters on the same day of HVPG measurement was calculated. CSPH and SPH were defined as a HVPG ≥10 mmHg and ≥12 mmHg respectively.
  
  
  RESULTS
  A total of 92 patients (male, 63; mean age, 53 ± 11.9 years) were eligible for analysis. CSPH and SPH were detected in 77 patients (83.7%) and 66 patients (71.5%) respectively. HVPG were significantly correlated with LSM in the overall, CSPH, and SPH patients (r = 0.646, 0.574 and 0.424 respectively; all P < 0.001). With ascites, the correlation coefficient did not decrease (r = 0.587). The AUROCs of LSM was 0.819 (95% CI, 0.725-0.892) for CSPH and 0.867 (95% CI, 0.780-0.928) for SPH. The cut-off values for determining CSPH and SPH were 15.2 kPa (Sensitivity, 85.7%; Specificity, 80.0%) and 21.6 kPa (Sensitivity, 83.3%; Specificity, 80.8%) respectively.
  
  
  CONCLUSIONS
  In cirrhotic patients, LSM by SWE is highly correlated with HVPG value regardless of ascites. SWE is a new reliable non-invasive diagnostic tool to predict CSPH and SPH, even in cirrhotic patients with ascites.
authors: Department of Internal Medicine, Hanyang University Guri Hospital and Hanyang University College of Medicine, Seoul, Korea.
authors: Tae Yeob
authors: TY
authors: Kim
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Woo Kyoung
authors: WK
authors: Jeong
authors: Department of Internal Medicine, Hanyang University Guri Hospital and Hanyang University College of Medicine, Seoul, Korea.
authors: Joo Hyun
authors: JH
authors: Sohn
authors: Department of Radiology, Ajou University Hospital, Ajou University College of Medicine, Suwon, Korea.
authors: Jinoo
authors: J
authors: Kim
authors: Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
authors: Min Yeong
authors: MY
authors: Kim
authors: Department of Radiology, Hanyang University Guri Hospital and Hanyang University College of Medicine, Seoul, Korea.
authors: Yongsoo
authors: Y
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000000981:diagnostic imaging; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
keywords: cirrhosis; elastography, shear wave; hepatic venous pressure gradient; liver stiffness; portal hypertension