Seung Woo Cha MD, Presenter: Nothing to Disclose

Woo Kyoung Jeong MD, Abstract Co-Author: Nothing to Disclose

Yong-Soo Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Min Yeong Kim MD, Abstract Co-Author: Nothing to Disclose

Soo-Yeon Kim, Abstract Co-Author: Nothing to Disclose

Dong-Woo Park MD, Abstract Co-Author: Nothing to Disclose

Choong-Ki Park MD, Abstract Co-Author: Nothing to Disclose

To assess the correlation between liver stiffness (LS) measured by Supersonic shear wave elastography (SSWE) and hepatic venous pressure gradient (HVPG), and to investigate the diagnostic performance of LS by SSWE for significant (HVPG ≥10 mmHg) and severe (≥12 mmHg) portal hypertension (PH).

This retrospective study was approved by our institutional review board, and written informed consent was waived. Clinical data of cirrhotic patients (n=105) with hemodynamic measurement along with healthy patients (n=11) were consecutively collected between September 2010 and January 2012. A healthy patient was defined as a person who showed no evidence of PH and was verified to have no significant fibrosis (≤F1 according to METAVIR score system) on liver biopsy. We repeatedly performed SSWE and calculated the median value (representing LS) and interquartile range divided by the median (IQR/M) from several measurements per patient. LS measurement was performed on the same day of HVPG measurement. Pearson correlation test and receiver operating characteristic curve (ROC) were used to evaluate the correlation and performance between LS and severity of PH.

Mean LS of cirrhotic and healthy patients were 28.2 and 6.43 kPa, respectively (P<.05). Mean IQR/M of cirrhotic and healthy patients were 0.12 and 0.15, respectively (P=.422). Of 116 patients, significant and severe PHT were in 93 patients (80.2%) and 81 patients (69.8%), respectively. The values of HVPG were moderately correlated with LS (r=0.575; 95% CI, 0.431-0.691; P<.05). The areas under the ROC curves for the diagnosis of significant and severe PH were 0.930 (95% CI, 0.868-0.969; P<.05) and 0.854 (95% CI, 0.777-0.913; P<.05), respectively. When the cut-off values for prediction of significant and severe PH were 15.2 and 18.5 kPa, respectively, the sensitivities were 90.3 % and 86.4%, and the specificities were 91.3% and 77.1%, respectively.

LS measured by SSWE is positively correlated with HVPG and it is useful to diagnose significant and severe PH.

It may be valuable to measure liver stiffness by Supersonic shear wave elastography in order to estimate the grades of portal hypertension non-invasively.

Cha, S, Jeong, W, Kim, Y, Kim, M, Kim, S, Park, D, Park, C, Efficacy of Liver Stiffness Measurement by Supersonic Shear Wave Elastography for Diagnosis of Significant and Severe Portal Hypertension in Chronic Liver Disease.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043431.html