Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
Abdom Radiol (NY). 2022 Nov;47(11):3712-3723. doi: 10.1007/s00261-022-03632-z. Epub 2022 Aug 9.
Hepatic venous pressure gradient (HVPG) is the gold standard for portal pressure in cirrhosis, but most previous studies focused on the diagnostic value of clinically significant portal hypertension (CSPH) based on the correlation between liver stiffness (LS) and HVPG in hepatitis C virus (HCV) patients and alcoholic liver. Therefore, it is necessary to clarify the diagnostic value of LS for CSPH and the correlation with HVPG in hepatitis B virus (HBV) patients.
A total of 137 patients from the Fifth Medical Center of PLA General Hospital were divided into HBV group and non-HBV group according to etiology. Correlation analysis and ROC were used to analyze the correlation between LS and HVPG and the diagnostic value of CSPH.
There was a good correlation between LS and HVPG in the total cohort and non-HBV cohort (r = 0.398, P < 0.001; r = 0.575, P < 0.001, respectively). However, the correlation between LS and HVPG was acceptable in the HBV cohort (r = 0.316, P = 0.002). When adjustment for age, MELD score, and INR, the result was still the same. Similar results were observed in the prediction for CSPH. LS showed good diagnostic value for CSPH in the total cohort and non-HBV cohort (AUC = 0.732, AUC = 0.829, respectively). However, it performed poorly in the HBV cohort (AUC = 0.689).
The etiology of HBV might affect the diagnostic performance of LS for predicting CSPH.
肝静脉压力梯度（HVPG）是肝硬化门静脉高压的金标准，但大多数先前的研究侧重于基于丙型肝炎病毒（HCV）患者和酒精性肝病中肝硬度（LS）与 HVPG 的相关性来诊断临床显著门静脉高压（CSPH）的诊断价值。因此，有必要阐明 LS 对 CSPH 的诊断价值及其与乙型肝炎病毒（HBV）患者 HVPG 的相关性。
根据病因将解放军总医院第五医学中心的 137 例患者分为 HBV 组和非 HBV 组。采用相关性分析和 ROC 分析 LS 与 HVPG 之间的相关性及 CSPH 的诊断价值。
总队列和非 HBV 队列中 LS 与 HVPG 之间存在良好的相关性（r=0.398，P<0.001；r=0.575，P<0.001）。然而，HBV 队列中 LS 与 HVPG 的相关性尚可（r=0.316，P=0.002）。调整年龄、MELD 评分和 INR 后，结果仍然相同。在 CSPH 的预测中也观察到了类似的结果。LS 在总队列和非 HBV 队列中对 CSPH 具有良好的诊断价值（AUC=0.732，AUC=0.829）。然而，在 HBV 队列中表现不佳（AUC=0.689）。
HBV 的病因可能会影响 LS 预测 CSPH 的诊断性能。
