Diagnosing and monitoring cirrhosis: Liver biopsy, hepatic venous pressure gradient and elastography

被引:33
作者
Abraldes, Juan G. [1 ,2 ]
Araujo, Isis K. [1 ]
Turon, Fanny [1 ]
Berzigotti, Annalisa [1 ,2 ,3 ]
机构
[1] Hosp Clin Barcelona, IDIBAPS, Unidad Hepatol, Barcelona, Spain
[2] CIBERehd, Barcelona, Spain
[3] Hosp Clin Barcelona, Ctr Diagnost Imagen, Barcelona, Spain
来源
GASTROENTEROLOGIA Y HEPATOLOGIA | 2012年 / 35卷 / 07期
关键词
Portal hypertension; Varices; Cirrosis; SIGNIFICANT PORTAL-HYPERTENSION; TRANSIENT ELASTOGRAPHY; STIFFNESS MEASUREMENT; NONINVASIVE ASSESSMENT; GASTROESOPHAGEAL VARICES; COMPENSATED CIRRHOSIS; ESOPHAGEAL-VARICES; ADVANCED FIBROSIS; NATURAL-HISTORY; RISK-ASSESSMENT;
D O I
10.1016/j.gastrohep.2012.02.010
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
In this review we summarize the role of liver biopsy, transient elastography and hepatic venous pressure gradient (HVPG) in the diagnosis and monitoring of patients with liver cirrhosis. Transient elastography is useful for the non-invasive diagnosis of cirrhosis, but relevant information is lost if it is used as a dichotomous test. The development of clinically significant portal hypertension (defined as a hepatic venous pressure gradient >= 10 mmHg) is associated with the development of varices and decompensation and it is something that it is worth testing for. Transient elastography has some value for the prediction of clinically significant portal hypertension, but a large proportion of patients have non-diagnostic values. It has also some value for the diagnosis of varices, but non-invasive markers cannot substitute endoscopic screening in cirrhosis. Better dynamic, easily repeatable non-invasive tools are needed to monitor compensated cirrhosis. (C) 2012 Elsevier Espana, S.L. and AEEH y AEG. All rights reserved.
引用
收藏
页码:488 / 495
页数:8
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