Zhonghua Yi Xue Za Zhi. 2023 Aug 29;103(32):2480-2494. doi: 10.3760/cma.j.cn112137-20230513-00782.
The population with cirrhosis in China is about 7 million, and portal hypertension is an important factor affecting the prognosis of these patients. The severity of portal hypertension determines the occurrence and development of liver related complications, such as ascites, variceal bleeding, and hepatic encephalopathy. In recent years, ultrasound elastography technology has been rapidly developed and widely applied in the field of liver diseases. Transient elastography, point shear wave elastography, and two-dimensional shear-wave elastography are all of great value for non-invasive evaluation of portal hypertension. However, there is currently no unified operating standard and reference threshold for evaluating cirrhotic portal hypertension using ultrasound elastography. Therefore, Ultrasonic Medicine Branch of the Chinese Medical Association and Chinese Portal Hypertension Alliance (CHESS) initialed and convened domestic experts from multiple disciplines, including ultrasound medicine, hepatology, gastroenterology, to form a consensus based on the latest domestic and international guidelines, medical evidence, and Chinese clinical practice. The aim is to standardize the examination process of different ultrasound elastography techniques, and standardize the application of liver stiffness and spleen stiffness in compensated advanced chronic liver disease, clinically significant portal hypertension, avoidance of endoscopic screening, risk stratification of portal hypertension, and personalized clinical management.
中国肝硬化患者人数约为700万，门静脉高压是影响这些患者预后的重要因素。门静脉高压的严重程度决定了肝脏相关并发症的发生和发展，如腹水、静脉曲张出血和肝性脑病。近年来，超声弹性成像技术迅速发展并广泛应用于肝脏疾病领域。瞬时弹性成像、点剪切波弹性成像和二维剪切波弹性成像在门静脉高压的无创评估中都具有重要价值。然而，目前使用超声弹性成像评估肝硬化门静脉高压尚无统一的操作标准和参考阈值。因此，中华医学会超声医学分会和中国门静脉高压联盟（CHESS）发起并召集了包括超声医学、肝病学、胃肠病学等多学科的国内专家，根据最新的国内外指南、医学证据和中国临床实践形成了共识。目的是规范不同超声弹性成像技术的检查流程，规范肝脏硬度和脾脏硬度在代偿期晚期慢性肝病、临床显著性门静脉高压、内镜筛查的避免、门静脉高压的风险分层和个性化临床管理中的应用。
