RISS 검색 - 국내학술지논문 상세보기

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다국어 초록 (Multilingual Abstract)

Aims: To investigate correlation between hepatic venous pressure gradient (HVPG) and transient elastography (TE) in patients with cirrhosis and identify a cut-off value of TE in clinically significant portal hypertension (CSPH, HVPG ≥10mmHg) and severe portal hypertension (SPH, HVPG >12 mmHg).
Methods: Between January 2008 and March 2017, 406 patients who underwent HVPG and TE were consecutively enrolled at the two Korean tertiary medical centers. HVPG and TE were performed within 1 month interval.
Results: The mean age was 53.1±9.9 years, and the majority (82%) were males. The most common etiology of cirrhosis was alcohol (63%) followed by hepatitis B virus infection (22%). A significant positive correlation was noted between liver stiffness and HVPG levels (r=0.549, p < 0.001). Figure presents the median TE values in various stages of portal hypertension (HVPG ≤ 5 mmHg, 9.8 kPa, HVPG > 5 to < 10 mmHg, 18.1 kPa, HVPG ≥ 10 to 12 mmHg, 27.0 kPa, HVPG > 12 to ≤ 20 mmHg, 41.3 kPa, HVPG > 20 mmHg, 62.7 kPa). The area under receiver operating characteristic curves for TE to diagnose portal hypertension (HVPG >5mmHg), CSPH, and SPH were 0.839 (95%CI: 0.737-0.941), 0.809 (95%CI: 0.761-0.858), and 0.782 (95%CI: 0.737-0.826), respectively. A cut-off values of TE of 27.2 and 35.5 kPa were obtained by using Youden index to best predict CSPH and SPH, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of a TE value ≥ 27.2 and ≥ 35.5 kPa to diagnose CSPH and SPH were 70.1%, 78.6%, 91.1%, and 45.6%, and 52.3%, 86.7%, 92.5%, 36.6%, respectively.
Conclusions: TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 27.2 and 35.6 kPa identifies CSPH and SPH with a PPV of 91.1% and 92.5%, respectively.