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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 7
Jul.  2014
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Article Contents

Current status and progress in noninvasive assessment of portal pressure

DOI: 10.3969/j.issn.1001-5256.2014.07.008
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  • Received Date: 2014-04-18
  • Published Date: 2014-07-20
  • Portal pressure assessment is a necessary means to diagnose portal hypertension. Currently, hepatic venous pressure gradient is considered as the diagnostic gold standard for portal hypertension. However, invasiveness is one of its most critical limitations. Therefore, a noninvasive, easy, and accurate measurement of portal pressure is of significant clinical value. The current noninvasive approaches to evaluate portal pressure, including CT portography, MR portography, Doppler ultrasonography, serum markers, and liver transient elastography, are summarized. Besides, a novel noninvasive portal pressure measurement technique based on the three- dimensional (3D) blood vessel model is introduced. It is pointed out that this method allows direct noninvasive measurement of portal pressure and establishment of 3D blood vessel model, as well as the diagnosis of portal hypertension based on directly simulated pressure indicators. However, this technique is being clinically tested, and its diagnostic accuracy needs to be further confirmed by large- sample clinical trials.

     

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  • [1]PROCOPEB, TANTAU M, BUREAU C.Are there any alternative methods to hepatic venous pressure gradient in portal hyperten-sion assessment?[J].J Gastrointestin Liver Dis, 2013, 22 (1) :73-78.
    [2]XU JM, SHI C, XU XY, et al.Noninvasive assessment of portal hypertension in patients with liver cirrhosis[J].Chin J Gastroenterol, 2013, 18 (6) :321-324. (in Chinese) 许建明, 时晨, 许晓勇, 等.肝硬化门静脉高压无创性检测方法的认识与评价[J].胃肠病学, 2013, 18 (6) :321-324.
    [3]KIM MY, JEONG WK, BAIK SK.Invasive and non-invasive diagnosis of cirrhosis and portal hypertension[J].World J Gastroenterol, 2014, 20 (15) :4300-4315.
    [4]LI HW, SI SM.Study on diagnostic value of multi-slice spiral CT angiography for pancreatic regional portal hypertension[J].Guide China Med, 2013, 11 (1) :94-95. (in Chinese) 李海文, 司素梅.多层螺旋CT血管造影在胰源性区域性门静脉高压症的诊断价值研究[J].中国医药指南, 2013, 11 (1) :94-95.
    [5]ZHANG YD, DU J, CHEN YL, et al.Application value of 64-slice spiral CT portal venography for portal hypertension[J].Current Physician, 2013, 19 (29) :40-41. (in Chinese) 张永东, 杜娟, 陈永泉, 等.64层螺旋CT门静脉造影在门静脉高压症中的应用价值[J].当代医学, 2013, 19 (29) :40-41.
    [6]LEE JY, KIM TY, JEONG WK, et al.Clinically severe portal hypertension:role of multi-detector row CT features in diagnosis[J].Dig Dis Sci, 2014.[Epub ahead of print]
    [7]DONG J, SUN HZ, WU SB.Magnetic resonance angiography in clinical application[J].China Med Device Infor, 2013, 19 (5) :41-43. (in Chinese) 董军, 孙洪珍, 吴树冰.磁共振血管造影在临床应用的新进展[J].中国医疗器械信息, 2013, 19 (5) :41-43.
    [8]ZHANG HB, HUANG HQ, LI J, et al.Value of three dimensional dynamic contrast enhanced MR portovenography in portal hypertension[J].Med J West China, 2011, 23 (8) :1566-1568. (in Chinese) 张海兵, 黄汉琴, 李君, 等.三维动态增强磁共振门脉成像在门脉高压症的应用价值[J].西部医学, 2011, 23 (8) :1566-1568.
    [9]RONOT M, LAMBERT S, ELKRIEF L, et al.Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis[J].Eur Radiol, 2014, 24 (6) :1394-1402.
    [10]LIU J.Application of color Doppler ultrasound in diagnosis of portal hypertension[J].J Med Theor&Prac, 2012, 25 (12) :1496-1497. (in Chinese) 刘军.彩色多普勒超声在门静脉高压症诊断中的应用[J].医学理论与实践, 2012, 25 (12) :1496-1497.
    [11]ZHANG L, YIN J, DUAN Y, et al.Assessment of intrahepatic blood flow by Doppler ultrasonography:Relationship between the hepatic vein, portal vein, hepatic artery and portal pressure measured intraoperatively in patients with portal hypertension[J].BMC Gastroenterol, 2011, 11:84.
    [12]BERZIGOTTI A, ASHKENAZI E, REVERTER E, et al.Non-invasive diagnostic and prognostic evaluation of liver cirrhosis and portal hypertension[J].Dis Markers, 2011, 31 (3) :129-138.
    [13]CUI YY, WANG L, ZHANG CX.Value of contrast-enhanced ul-trasound and color Doppler in diagnosing portal hypertension esophageal varices[J].Acta Univ Med Anhui, 2014, 49 (1) :96-99. (in Chinese) 崔亚云, 王玲, 张超学.超声造影及彩色多普勒参数对门静脉高压食管静脉曲张的诊断价值[J].安徽医科大学学报, 2014, 49 (1) :96-99.
    [14]LIU W.Diagnosis value of color Doppler ultrasound on senile cirrhotic portal hypertension[J].J Hebei Med, 2014, 20 (4) :576-578. (in Chinese) 刘伟.彩色多普勒超声对老年肝硬化门静脉高压症的诊断价值[J].河北医学, 2014, 20 (4) :576-578.
    [15]HAN Y, LIU LX.Serological diagnosis markers for liver fibrosis[J/CD].Chin J Digest Med Imageol:Electronic Edition, 2013, 3 (4) :35-41. (in Chinese) 韩轶, 刘立新.肝纤维化血清学诊断指标研究进展[J].中华消化病与影像杂志:电子版, 2013, 3 (4) :35-41.
    [16]BUREAU C, METIVIER S, PERON JM, et al.Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease[J].Aliment Pharmacol Ther, 2008, 27 (12) :1261-1268.
    [17]PARK SH, PARK TE, KIM YM, et al.Non-invasive model predicting clinically-significant portal hypertension in patients with advanced fibrosis[J].J Gastroenterol Hepatol, 2009, 24 (7) :1289-1293.
    [18]SNOWDON VK, GUHA N, FALLOWFIELD JA.Noninvasive evaluation of portal hypertension:emerging tools and techniques[J].Int J Hepatol, 2012, 2012:691089.
    [19]BERZIGOTTI A, SEIJO S, ARENA U, et al.Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis[J].Gastroenterology, 2013, 144 (1) :102-111.
    [20]CASTERA L, PINZANI M, BOSCH J.Noninvasive evaluation of portal hypertension using transient elastography[J].J Hepatol, 2011, 56 (3) :696-703.
    [21]BERZIGOTTI A, BOSCH J.Use of non-invasive markers of portal hypertension and timing of screening endoscopy for gastroesophageal varices in patients with chronic liver disease[J].Hepatology, 2014, 59 (2) :729-731.
    [22]RUDLER M, POYNARD T, THABUT D.Liver stiffness, platelets, and spleen size is reliable in nondecompensated cirrhotic patients[J].Gastroenterology, 2013, 144 (5) :1150.
    [23]KOO BK, ERGLIS A, DOH JH, et al.Diagnosis of ischemiacausing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study[J].J Am Coll Cardiol, 2011, 58 (19) :1989-1997.
    [24]QI X, LV H, ZHOU F, et al.A novel noninvasive method for measuring fractional flow reserve through three-dimensional modeling[J].Arch Med Sci, 2013, 9 (3) :581-583.
    [25]QI X, XU M, LI Z, et al.Virtual portal pressure from anatomic CT angiography[J].J Hepatol, 2014.[Epub ahead of print]
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