Clin Mol Hepatol.  2017 Mar;23(1):34-41. 10.3350/cmh.2016.0059.

Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis

• Kim G
• Kim MY
• Baik SK

• KMID: 2412112
• DOI: http://doi.org/10.3350/cmh.2016.0059

Abstract

BACKGROUND/AIMS
Transient elastography (TE) has been proposed as a promising noninvasive alternative to hepatic venous pressure gradient (HVPG) for detecting portal hypertension (PH). However, previous studies have yielded conflicting results. We gathered evidence from literature on the clinical usefulness of TE versus HVPG for assessing PH.
METHODS
We conducted a systematic review by searching databases for relevant literature evaluating the clinical usefulness of non-invasive TE for assessing PH in patients with cirrhosis. A literature search in Ovid Medline, EMBASE and the Cochrane Library was performed for all studies published prior to December 30, 2015.
RESULTS
Eight studies (1,356 patients) met our inclusion criteria. For the detection of PH (HVPG ≥6 mmHg), the summary sensitivity and specificity were 0.88 (95% confidence interval [CI] 0.86-0.90) and 0.74 (95% CI 0.67-0.81), respectively. Regarding clinically significant PH (HVPG ≥10 mmHg), the summary sensitivity and specificity were 0.85 (95% CI 0.63-0.97) and 0.71 (95% CI 0.50-0.93), respectively. The overall correlation estimate of TE and HVPG was large (0.75, 95% CI: 0.65; 0.82, P<0.0001).
CONCLUSIONS
TE showed high accuracy and correlation for detecting the severity of PH. Therefore, TE shows promise as a reliable and non-invasive procedure for the evaluation of PH that should be integrated into clinical practice.

Keyword

Elastography; Hypertension, Portal; Liver cirrhosis; Review, Systematic; Meta-analysis

MeSH Terms

Area Under Curve
Databases, Factual
*Elasticity Imaging Techniques
Humans
Hypertension, Portal/*diagnosis/diagnostic imaging
Liver Cirrhosis/diagnosis
Portal Pressure/*physiology
ROC Curve
Sensitivity and Specificity