Liver and Spleen Stiffness to Predict Portal Hypertension and Its Complications

Mendoza, Yuly P.; Murgia, Giuseppe; Rodrigues, Susana G.; Delgado, Maria G.; Berzigotti, Annalisa (2020). Liver and Spleen Stiffness to Predict Portal Hypertension and Its Complications. In: Mueller, Sebastian (ed.) Liver Elastography (pp. 325-359). Cham: Springer 10.1007/978-3-030-40542-7_31

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Portal hypertension is a common syndrome characterized by an increase in portal venous pressure driving life-threatening complications. In advanced chronic liver disease, increased portal venous pressure is one of the hallmarks of progression; in this scenario, portal hypertension is best diagnosed by the invasive measurement of hepatic venous pressure gradient (HVPG). In the last 10 years, ultrasound elastography techniques emerged as valuable non-invasive tools in the field of portal hypertension. It is now possible to identify patients with clinically significant portal hypertension and to guide the selection of patients requiring endoscopy to screen for varices at risk of bleeding using elastography techniques. In addition to liver stiffness measurement (LSM), spleen stiffness measurement (SSM) using transient elastography, point shear wave elastography, and 2D shear-wave elastography have been tested in this setting. This chapter provides an updated summary of the rationale and use of ultrasound elastography to diagnose, stage, and follow up portal hypertension and its complications.

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