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Noninvasive imaging assessment of portal hypertension

  • Special Section: Diffuse Liver Disease.
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Portal hypertension (PH) is a spectrum of complications of chronic liver disease (CLD) and cirrhosis, with manifestations including ascites, gastroesophageal varices, splenomegaly, hypersplenism, hepatic hydrothorax, hepatorenal syndrome, hepatopulmonary syndrome and portopulmonary hypertension. PH can vary in severity and is diagnosed via invasive hepatic venous pressure gradient measurement (HVPG), which is considered the reference standard. Accurate diagnosis of PH and assessment of severity are highly relevant as patients with clinically significant portal hypertension (CSPH) are at higher risk for developing acute variceal bleeding and mortality. In this review, we discuss current and upcoming noninvasive imaging methods for diagnosis and assessment of severity of PH.

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Abbreviations

ALT:

Alanine aminotransferase

APRI:

AST-to-platelet ratio index

AST:

Aspartate aminotransferase

cACLD:

Compensated advanced chronic liver disease

CLD:

Chronic liver disease

CP:

Child–Pugh

CSPH:

Clinically significant portal hypertension

CT:

Computed tomography

ECV:

Extracellular volume fraction

HABR:

Hepatic arterial buffer response

HVPG:

Hepatic venous pressure gradient

INR:

International normalized ratio

LS:

Liver stiffness

MELD:

Model for end-stage liver disease

MRE:

Magnetic resonance elastography

MRI:

Magnetic resonance imaging

PH:

Portal hypertension

PV:

Portal vein

SS:

Spleen stiffness

TE:

Transient elastography

US:

Ultrasound

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Author notes

  1. Paul Kennedy and Octavia Bane have contributed equally to this work.

Authors and Affiliations

  1. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA

    Paul Kennedy, Octavia Bane, Stefanie J. Hectors, Sara Lewis & Bachir Taouli

  2. Department of Radiology, Weill Cornell Medicine, New York, NY, USA

    Stefanie J. Hectors

  3. Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA

    Aaron Fischman, Sara Lewis & Bachir Taouli

  4. Division of Liver Diseases, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Thomas Schiano

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  1. Paul Kennedy
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  2. Octavia Bane
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  3. Stefanie J. Hectors
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Correspondence to Bachir Taouli.

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Kennedy, P., Bane, O., Hectors, S.J. et al. Noninvasive imaging assessment of portal hypertension. Abdom Radiol 45, 3473–3495 (2020). https://doi.org/10.1007/s00261-020-02729-7

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  • DOI: https://doi.org/10.1007/s00261-020-02729-7

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