Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease

Aliment Pharmacol Ther. 2008 Jun;27(12):1261-8. doi: 10.1111/j.1365-2036.2008.03701.x. Epub 2008 Apr 4.


Background: Hepatic venous pressure gradient (HVPG) is a prognostic marker in patients with cirrhosis. Transient elastography measures liver stiffness (LS).

Aim: To assess the correlation between LS and HVPG and to investigate the performance of transient elastography for the diagnosis of significant portal hypertension (PHT).

Methods: Liver stiffness was measured by Fibroscan in 150 consecutive patients who underwent a liver biopsy with haemodynamic measurements. Usual clinical and biological data were collected. Significant PHT was defined as a HVPG > or = 10 mmHg.

Results: Hepatic venous pressure gradient was found to be > or = 10 mmHg in 76 patients. Cirrhosis was diagnosed in 89 patients. HVPG was found to be correlated with: LS (rho = 0.858; P < 0.001) and inversely correlated with prothrombin index (rho = -0.718; P < 0.001). Regarding significant PHT, AUROC for LS and prothrombin index were 0.945 [0.904-0.987] and 0.892 [0.837-0.947] respectively. The cut-off value of 21 kPa accurately predicted significant PHT in 92% of the 144 patients for whom LS was successful.

Conclusion: Liver stiffness measurement is correlated with HVPG and transient elastography identifies patients with significant PHT.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Elasticity Imaging Techniques / methods*
  • Female
  • Hemodynamics
  • Hepatic Veins / physiopathology*
  • Humans
  • Hypertension, Portal / complications
  • Hypertension, Portal / diagnosis*
  • Hypertension, Portal / physiopathology
  • Liver / physiology*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Portal Vein / physiopathology*
  • Predictive Value of Tests
  • Treatment Outcome