AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r=0.83, P<0.0001) and with the Child-Pugh score (r=0.63, P<0.0001). An acceleration index cut-off value of 1m.s(-2) provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient>12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r=0.45,P=0.01) and portal vein velocity (r=0.40,P=0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension.
AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r=0.83, P<0.0001) and with the Child-Pugh score (r=0.63, P<0.0001). An acceleration index cut-off value of 1m.s(-2) provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient>12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r=0.45,P=0.01) and portal vein velocity (r=0.40,P=0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension.
Authors: Gaeun Kim; Youn Zoo Cho; Soon Koo Baik; Moon Young Kim; Won Ki Hong; Sang Ok Kwon Journal: Korean J Radiol Date: 2015-02-27 Impact factor: 3.500
Authors: M Mohty; F Malard; M Abecassis; E Aerts; A S Alaskar; M Aljurf; M Arat; P Bader; F Baron; A Bazarbachi; D Blaise; F Ciceri; S Corbacioglu; J-H Dalle; F Dignan; T Fukuda; A Huynh; T Masszi; M Michallet; A Nagler; M NiChonghaile; S Okamoto; A Pagliuca; C Peters; F B Petersen; P G Richardson; T Ruutu; B N Savani; E Wallhult; I Yakoub-Agha; R F Duarte; E Carreras Journal: Bone Marrow Transplant Date: 2016-05-16 Impact factor: 5.483