Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Switzerland.
J Hepatol. 2017 Aug;67(2):399-411. doi: 10.1016/j.jhep.2017.02.003. Epub 2017 Feb 14.
Portal hypertension (PH) leads to serious complications, such as bleeding from gastroesophageal varices, ascites and portosystemic encephalopathy in patients with chronic liver disease (CLD). Gold standard methods for assessing PH and its complications include the measurement of hepatic venous pressure gradient and endoscopy; however, these are invasive, expensive and not available at all centres. Therefore, non-invasive alternatives have been the subject of extensive investigation over the last 20years. The present review focuses on the role of ultrasound elastography - a novel group of non-invasive techniques used to measure stiffness in target organs. In the context of CLD these methods are used to identify the presence of PH, its severity, and the risk of PH-related complications. The rationale, accumulated evidence, advantages and limitations of liver and spleen stiffness measurements evaluated by different ultrasound elastography techniques in patients with advanced CLD is discussed. Recent data regarding the use of ultrasound elastography techniques in patients with non-cirrhotic forms of PH are also described.
门静脉高压（PH）可导致严重并发症，如慢性肝病（CLD）患者的食管胃静脉曲张出血、腹水和门脉系统脑病。评估 PH 及其并发症的金标准方法包括肝静脉压力梯度测量和内镜检查；然而，这些方法具有侵袭性、昂贵且并非所有中心都能提供。因此，在过去的 20 年中，人们一直在广泛研究非侵入性替代方法。本综述重点介绍了超声弹性成像的作用，这是一组用于测量目标器官硬度的新型非侵入性技术。在 CLD 的背景下，这些方法用于识别 PH 的存在、严重程度以及与 PH 相关并发症的风险。讨论了不同超声弹性成像技术评估的肝和脾硬度测量在晚期 CLD 患者中的原理、累积证据、优势和局限性。还描述了关于在非肝硬化 PH 患者中使用超声弹性成像技术的最新数据。
