Hepatic venous pressure gradient correlates with advanced hepatic fibrosis: a retrospective review

被引:3
|
作者
Vincent, Jonathan K. [1 ]
Stark, Christopher [2 ]
Shields, Joseph T. [3 ]
Bhave, Anant D. [3 ]
Morris, Christopher S. [3 ,4 ]
机构
[1] Beth Israel Deaconess Plymouth Hosp, Dept Radiol, Plymouth, MA USA
[2] Albany Med Ctr, Dept Radiol, Albany, NY USA
[3] Univ Vermont, Dept Radiol, Larner Coll Med, Burlington, VT 05401 USA
[4] Univ Vermont, Patrick Radiol 1, Med Ctr, 111 Colchester Ave, Burlington, VT 05401 USA
关键词
Biopsy; Transjugular; Liver; Wedge; Pressure; Fibrosis; PORTAL-HYPERTENSION; PROGNOSTIC VALUE; CLINICAL-USE; HISTOLOGICAL SUBCLASSIFICATION; GASTROESOPHAGEAL VARICES; HEPATOCELLULAR-CARCINOMA; LIVER-BIOPSY; CIRRHOSIS; CLASSIFICATION; HVPG;
D O I
10.1007/s00261-017-1171-y
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To determine if hepatic venous pressure gradient (HVPG) correlates with advanced hepatic fibrosis, as a complement to transjugular (transvenous) core needle liver biopsy. Material and methods: After institutional review board approval, a retrospective review was conducted on 340 patients who underwent transjugular (transvenous) core needle liver biopsy with concurrent pressure measurements between 6/1/2007 and 6/1/2013. Spearman correlation and linear regression were performed. A receiver operating characteristic (ROC) curve was created and sensitivity, specificity, predictive values and likelihood ratios were calculated. Results: Indications included hepatitis C, abnormal liver function tests, non-alcoholic steatohepatitis, autoimmune hepatitis, and cirrhosis, among others. Biopsies showed stage 1 or 2 fibrosis in 15.6% each, stage 3 fibrosis in 21.6%, stage 4 fibrosis in 40.7%, and no fibrosis in 6.5%. Mean HVPG was 6.5 mm Hg (SD 5.0) with a range of 0-26 mm Hg. Spearman correlation coefficient for association between HVPG and fibrosis stage was 0.561 (p < 0.001). R2 on linear regression was 0.247 (p < 0.001). ROC curve for the prediction of stage 4 fibrosis had an area under the curve of 0.79 (95% CI 0.73-0.85). HVPG of >6 mm Hg had a sensitivity of 71.3%, specificity of 79.6%, positive predictive value of 70.5%, negative predictive value of 80.2%, positive likelihood ratio of 3.49 (95% CI 2.45-4.97) and negative likelihood ratio of 0.36 (95% CI 0.26-0.50) for diagnosis of stage 4 fibrosis. Conclusions: HVPG correlates with stage 4 (advanced) hepatic fibrosis.
引用
收藏
页码:2609 / 2614
页数:6
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