Liver Stiffness by Transient Elastography to Detect Porto-Sinusoidal Vascular Liver Disease With Portal Hypertension.
Adult
Aged
Biopsy
Diagnosis, Differential
Elasticity Imaging Techniques
Feasibility Studies
Female
Hepatic Veno-Occlusive Disease
/ complications
Humans
Hypertension, Portal
/ etiology
Liver
/ blood supply
Liver Cirrhosis
/ complications
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Journal
Hepatology (Baltimore, Md.)
ISSN: 1527-3350
Titre abrégé: Hepatology
Pays: United States
ID NLM: 8302946
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
19
11
2020
received:
23
09
2020
accepted:
04
12
2020
pubmed:
22
12
2020
medline:
5
1
2022
entrez:
21
12
2020
Statut:
ppublish
Résumé
Porto-sinusoidal vascular liver disease (PSVD) is a rare cause of portal hypertension. PSVD is still often misdiagnosed as cirrhosis, emphasizing the need to improve PSVD diagnosis strategies. Data on liver stiffness measurement using transient elastography (TE-LSM) in PSVD are limited. The aim of this study was to evaluate the accuracy of TE-LSM to discriminate PSVD from cirrhosis in patients with signs of portal hypertension. Retrospective multicenter study comparing TE-LSM in patients with PSVD, according to Vascular Liver Disease Interest Group criteria, with patients with compensated biopsy-proven cirrhosis associated with alcohol (n = 117), HCV infection (n = 110), or NAFLD (n = 46). All patients had at least one sign of portal hypertension among gastroesophageal varices, splenomegaly, portosystemic collaterals, history of ascites, or platelet count < 150 × 10 This study including a total of 155 patients with PSVD and 273 patients with cirrhosis demonstrates that TE-LSM < 10 kPa strongly suggests PSVD in patients with signs of portal hypertension. Conversely, when TE-LSM is >20 kPa, PSVD is highly unlikely.
Sections du résumé
BACKGROUND AND AIMS
Porto-sinusoidal vascular liver disease (PSVD) is a rare cause of portal hypertension. PSVD is still often misdiagnosed as cirrhosis, emphasizing the need to improve PSVD diagnosis strategies. Data on liver stiffness measurement using transient elastography (TE-LSM) in PSVD are limited. The aim of this study was to evaluate the accuracy of TE-LSM to discriminate PSVD from cirrhosis in patients with signs of portal hypertension.
APPROACH AND RESULTS
Retrospective multicenter study comparing TE-LSM in patients with PSVD, according to Vascular Liver Disease Interest Group criteria, with patients with compensated biopsy-proven cirrhosis associated with alcohol (n = 117), HCV infection (n = 110), or NAFLD (n = 46). All patients had at least one sign of portal hypertension among gastroesophageal varices, splenomegaly, portosystemic collaterals, history of ascites, or platelet count < 150 × 10
CONCLUSIONS
This study including a total of 155 patients with PSVD and 273 patients with cirrhosis demonstrates that TE-LSM < 10 kPa strongly suggests PSVD in patients with signs of portal hypertension. Conversely, when TE-LSM is >20 kPa, PSVD is highly unlikely.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
364-378Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 by the American Association for the Study of Liver Diseases.
Références
De Gottardi A, Rautou PE, Schouten J, Rubbia-Brandt L, Leebeek F, Trebicka J, et al. Porto-sinusoidal vascular disease: proposal and description of a novel entity. Lancet Gastroenterol Hepatol 2019;4:399-411.
Krasinskas AM, Goldsmith JD, Burke A, Furth EE. Abnormal intrahepatic portal vasculature in native and allograft liver biopsies: a comparative analysis. Am J Surg Pathol 2005;29:1382-1388.
Meijer B, Simsek M, Blokzijl H, de Man RA, Coenraad MJ, Dijkstra G, et al. Nodular regenerative hyperplasia rarely leads to liver transplantation: a 20-year cohort study in all Dutch liver transplant units. United Eur Gastroenterol J 2017;5:658-667.
Hillaire S, Cazals-Hatem D, Bruno O, de Miranda S, Grenet D, Poté N, et al. Liver transplantation in adult cystic fibrosis: clinical, imaging, and pathological evidence of obliterative portal venopathy. Liver Transpl 2017;23:1342-1347.
Cazals-Hatem D, Hillaire S, Rudler M, Plessier A, Paradis V, Condat B, et al. Obliterative portal venopathy: portal hypertension is not always present at diagnosis. J Hepatol 2011;54:455-461.
Jharap B, van Asseldonk DP, de Boer NKH, Bedossa P, Diebold J, Jonker AM, et al. Diagnosing nodular regenerative hyperplasia of the liver is thwarted by low interobserver agreement. PLoS One 2015;10:e0120299.
Carrat F, Fontaine H, Dorival C, Simony M, Diallo A, Hezode C, et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study. Lancet Lond Engl 2019;393:1453-1464.
Yip TCF, Wong GLH, Chan HLY, Tse YK, Lam KLY, Lui GCY, et al. HBsAg seroclearance further reduces hepatocellular carcinoma risk after complete viral suppression with nucleos(t)ide analogues. J Hepatol 2019;70:361-370.
Bureau C, Metivier S, Peron JM, Selves J, Robic MA, Gourraud PA, et al. Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease. Aliment Pharmacol Ther 2008;27:1261-1268.
Vizzutti F, Arena U, Romanelli RG, Rega L, Foschi M, Colagrande S, et al. Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis. Hepatology 2007;45:1290-1297.
Berzigotti A, Seijo S, Arena U, Abraldes JG, Vizzutti F, García-Pagán JC, et al. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis. Gastroenterology 2013;144:102-111.e1.
de Franchis R, Faculty BV. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol 2010;53:762-768.
Berzigotti A. Non-invasive evaluation of portal hypertension using ultrasound elastography. J Hepatol 2017;67:399-411.
You MW, Kim KW, Pyo J, Huh J, Kim HJ, Lee SJ, et al. A meta-analysis for the diagnostic performance of transient elastography for clinically significant portal hypertension. Ultrasound Med Biol 2017;43:59-68.
Abraldes JG, Bureau C, Stefanescu H, Augustin S, Ney M, Blasco H, et al. Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: the “Anticipate” study. Hepatology 2016;64:2173-2184.
Augustin S, Pons M, Maurice JB, Bureau C, Stefanescu H, Ney M, et al. Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease. Hepatology 2017;66:1980-1988.
Thabut D, Bureau C, Layese R, Bourcier V, Hammouche M, Cagnot C, et al. Validation of Baveno VI criteria for screening and surveillance of esophageal varices in patients with compensated cirrhosis and a sustained response to antiviral therapy. Gastroenterology 2019;156:997-1009.e5.
Laharie D, Vergniol J, Bioulac-Sage P, Diris B, Poli J, Foucher J, et al. Usefulness of noninvasive tests in nodular regenerative hyperplasia of the liver. Eur J Gastroenterol Hepatol 2010;22:487-493.
Sharma P, Agarwal R, Dhawan S, Bansal N, Singla V, Kumar A, et al. Transient elastography (fibroscan) in patients with non-cirrhotic portal fibrosis. J Clin Exp Hepatol 2017;7:230-234.
Seijo S, Reverter E, Miquel R, Berzigotti A, Abraldes JG, Bosch J, et al. Role of hepatic vein catheterisation and transient elastography in the diagnosis of idiopathic portal hypertension. Dig Liver Dis 2012;44:855-860.
Chougule A, Rastogi A, Maiwall R, Bihari C, Sood V, Sarin SK. Spectrum of histopathological changes in patients with non-cirrhotic portal fibrosis. Hepatol Int 2018;12:158-166.
Guido M, Alves VAF, Balabaud C, Bathal PS, Bioulac-Sage P, Colombari R, et al. Histology of portal vascular changes associated with idiopathic non-cirrhotic portal hypertension: nomenclature and definition. Histopathology 2019;74:219-226.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008;61:344-349.
Ganne-Carrié N, Chaffaut C, Bourcier V, Archambeaud I, Perarnau JM, Oberti F, et al. Estimate of hepatocellular carcinoma incidence in patients with alcoholic cirrhosis. J Hepatol 2018;69:1274-1283.
Nahon P, Bourcier V, Layese R, Audureau E, Cagnot C, Marcellin P, et al. Eradication of hepatitis C virus infection in patients with cirrhosis reduces risk of liver and non-liver complications. Gastroenterology 2017;152:142-156.e2.
Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol 2008;48:835-847.
Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology 1996;24:289-293.
Hollande C, Mallet V, Darbeda S, Vallet-Pichard A, Fontaine H, Verkarre V, et al. Impact of obliterative portal venopathy associated with human immunodeficiency virus. Medicine (Baltimore) 2016;95:e3081.
Vuppalanchi R, Mathur K, Pyko M, Samala N, Chalasani N. Liver stiffness measurements in patients with noncirrhotic portal hypertension-the devil is in the details. Hepatology 2018;68:2438-2440.
European Association for Study of Liver, Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015;63:237-264.
Nguyen-Khac E, Thiele M, Voican C, Nahon P, Moreno C, Boursier J, et al. Non-invasive diagnosis of liver fibrosis in patients with alcohol-related liver disease by transient elastography: an individual patient data meta-analysis. Lancet Gastroenterol Hepatol 2018;3:614-625.
Eddowes PJ, Sasso M, Allison M, Tsochatzis E, Anstee QM, Sheridan D, et al. Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterology 2019;156:1717-1730.
Jansen C, Bogs C, Verlinden W, Thiele M, Möller P, Görtzen J, et al. Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension: a prospective multicentre study. Liver Int 2017;37:396-405.
Usher-Smith JA, Sharp SJ, Griffin SJ. The spectrum effect in tests for risk prediction, screening, and diagnosis. BMJ 2016;353:i3139.
Colecchia A, Montrone L, Scaioli E, Bacchi-Reggiani ML, Colli A, Casazza G, et al. Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. Gastroenterology 2012;143:646-654.
Cowan DH, Hines JD. Thrombocytopenia of severe alcoholism. Ann Intern Med 1971;74:37-43.
Bendtsen F, Skovgaard LT, Sørensen TI, Matzen P. Agreement among multiple observers on endoscopic diagnosis of esophageal varices before bleeding. Hepatology 1990;11:341-347.
Bedossa P, Dargère D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 2003;38:1449-1457.
Rousselet MC, Michalak S, Dupré F, Croué A, Bedossa P, Saint-André J-P, et al. Sources of variability in histological scoring of chronic viral hepatitis. Hepatology 2005;41:257-264.
Buzzetti E, Hall A, Ekstedt M, Manuguerra R, Guerrero Misas M, Covelli C, et al. Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2019;49:1214-1222.
Cardoso AC, Beaugrand M, de Ledinghen V, Douvin C, Poupon R, Trinchet JC, et al. Diagnostic performance of controlled attenuation parameter for predicting steatosis grade in chronic hepatitis B. Ann Hepatol 2015;14:826-836.
Millonig G, Friedrich S, Adolf S, Fonouni H, Golriz M, Mehrabi A, et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol 2010;52:206-210.
Ratziu V, Valla D, Rautou PE. Arterial hypertension as an uninvited player in hepatic stiffness? Am J Physiol Gastrointest Liver Physiol 2016;311:G942-G944.
D’Ambrosio R, Aghemo A, Rumi MG, Ronchi G, Donato MF, Paradis V, et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology 2012;56:532-543.
D’Ambrosio R, Aghemo A, Fraquelli M, Rumi MG, Donato MF, Paradis V, et al. The diagnostic accuracy of Fibroscan for cirrhosis is influenced by liver morphometry in HCV patients with a sustained virological response. J Hepatol 2013;59:251-256.