Clin Mol Hepatol.  2013 Dec;19(4):370-375. 10.3350/cmh.2013.19.4.370.

The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data

• Hong WK
• Kim MY
• Baik SK
• Shin SY
• Kim JM
• Kang YS
• Lim YL
• Kim YJ
• Cho YZ
• Hwang HW
• Lee JH
• Chae MH
• Kim HA
• Kang HW
• Kwon SO

• KMID: 1730882
• DOI: http://doi.org/10.3350/cmh.2013.19.4.370

Abstract

BACKGROUND/AIMS
Liver stiffness measurement (LSM) has been proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. In this study we evaluated the relationship between LSM and HVPG, and the predictive value of LSM for clinically significant portal hypertension (CSPH) and severe portal hypertension in cirrhosis.
METHODS
LSM was performed with transient elastography in 59 consecutive cirrhotic patients who underwent hemodynamic HVPG investigations. CSPH and severe portal hypertension were defined as HVPG > or =10 and > or =12 mmHg, respectively. Linear regression analysis was performed to evaluate the relationship between LSM and HVPG. Diagnostic values were analyzed based on receiver operating characteristic (ROC) curves.
RESULTS
A strong positive correlation between LSM and HVPG was observed in the overall population (r2=0.496, P<0.0001). The area under the ROC curve (AUROC) for the prediction of CSPH (HVPG > or =10 mmHg) was 0.851, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for an LSM cutoff value of 21.95 kPa were 82.5%, 73.7%, 86.8%, and 66.7%, respectively. The AUROC at prediction of severe portal hypertension (HVPG > or =12 mmHg) was 0.877, and the sensitivity, specificity, PPV, and NPV at LSM cutoff value of 24.25 kPa were 82.9%, 70.8%, 80.6%, and 73.9%, respectively.
CONCLUSIONS
LSM exhibited a significant correlation with HVPG in patients with cirrhosis. LSM could be a non-invasive method for predicting CSPH and severe portal hypertension in Korean patients with liver cirrhosis.

Keyword

Portal hypertension; Liver stiffness measurement; Cirrhosis

MeSH Terms

Adult
Aged
Alcohol-Related Disorders/complications
Area Under Curve
*Elasticity Imaging Techniques
Female
Hepatitis B/complications
Hepatitis C/complications
Humans
Hypertension, Portal/*complications/*diagnosis
Linear Models
Liver Cirrhosis/*complications/*diagnosis/pathology
Male
Middle Aged
ROC Curve
Republic of Korea
Sensitivity and Specificity