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Portal hypertension (PH), a superior complication of liver cirrhosis, is defined arsenic a unit gradient > 5 mmHg betwixt nan portal vein and nan inferior vena cava. When nan hepatic venous unit gradient (HVPG) exceeds 10 mmHg, nan information becomes clinically significant, and complications emergence substantially, making early discovery captious for guiding treatment.
A caller reappraisal made disposable online connected March 1, 2025, and published connected March 17, 2025, successful nan Portal Hypertension & Cirrhosis diary explores whether advances successful ultrasound exertion tin connection a reliable, non-invasive method for evaluating PH.
PH develops erstwhile guidance to humor travel done nan liver increases, astir often owed to cirrhosis, raising unit successful nan portal venous system. The reappraisal describes really different ultrasound techniques tin observe these changes.
Traditional B-mode ultrasound tin uncover structural features of cirrhosis specified arsenic a nodular liver surface, altered liver shape, and enlarged vessels, arsenic good arsenic indirect signs of PH, including splenomegaly and ascites.
Doppler ultrasound allows clinicians to measure humor travel guidance and velocity successful nan portal vein and surrounding vessels. In cirrhosis, portal vein travel often slows, and successful terrible cases, it whitethorn reverse direction, a shape known arsenic hepatofugal travel that indicates precocious PH.
Because nary azygous measurement afloat captures illness severity, clinicians measure respective ultrasound parameters together, an attack known arsenic multiparametric ultrasound.
Elastography, different method discussed successful nan review, measures liver stiffness, arsenic an parameter of fibrosis progresses and PH severity.
The researchers besides item contrast-enhanced ultrasound, that characterizes hepatic humor travel by search an injected opposition supplier done liver vessels, clinicians; however, individual variations successful travel patterns and nan improvement of collateral vessels tin complicate interpretation.
While ultrasound cannot yet afloat switch invasive unit measurements, multiparametric ultrasound offers a practical, noninvasive replacement that whitethorn thief clinicians amended understand nan analyzable changes that hap successful liver illness and support some diligent monitoring and objective decision-making.
Notably, nan study besides offers scenario-specific ultrasound recommendations, adding applicable worth for clinicians and researchers.
Source:
Journal reference:
Möller, K., et al. (2025). Portal Hypertension—Noninvasive Multiparametric Ultrasound‐Based Criteria and Measurements. Portal Hypertension & Cirrhosis. DOI: 10.1002/poh2.70002. https://onlinelibrary.wiley.com/doi/10.1002/poh2.70002
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