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      Quantification of Liver Surface Nodularity at CT: Utility for Detection of Portal Hypertension

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          Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease

          Patients with compensated advanced chronic liver disease (cACLD) can safely avoid screening endoscopy with a platelet count >150 × 109 cells/L and a liver stiffness measurement (LSM) 110 × 109 cells/L and LSM <25 kPa. This was validated in the two additional cohorts. Overall, the Expanded-Baveno VI criteria would potentially spare 367 (40%) endoscopies (21% with Baveno VI criteria) with a risk of missing VNT of 1.6% (95% confidence interval, 0.7%-3.5%) in patients within the criteria and 0.6% (95% confidence interval, 0.3%-1.4%) in the overall population of 925 patients evaluated. The Expanded-Baveno VI criteria performed well in patients with cACLD with hepatitis C virus and alcoholic and nonalcoholic steatohepatitis.
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            The hepatic venous pressure gradient: anything worth doing should be done right.

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              Non-invasive evaluation of portal hypertension using ultrasound elastography.

              Portal hypertension (PH) leads to serious complications, such as bleeding from gastroesophageal varices, ascites and portosystemic encephalopathy in patients with chronic liver disease (CLD). Gold standard methods for assessing PH and its complications include the measurement of hepatic venous pressure gradient and endoscopy; however, these are invasive, expensive and not available at all centres. Therefore, non-invasive alternatives have been the subject of extensive investigation over the last 20years. The present review focuses on the role of ultrasound elastography - a novel group of non-invasive techniques used to measure stiffness in target organs. In the context of CLD these methods are used to identify the presence of PH, its severity, and the risk of PH-related complications. The rationale, accumulated evidence, advantages and limitations of liver and spleen stiffness measurements evaluated by different ultrasound elastography techniques in patients with advanced CLD is discussed. Recent data regarding the use of ultrasound elastography techniques in patients with non-cirrhotic forms of PH are also described.
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                Author and article information

                Journal
                Radiology
                Radiology
                Radiological Society of North America (RSNA)
                0033-8419
                1527-1315
                December 2018
                December 2018
                : 289
                : 3
                : 698-707
                Article
                10.1148/radiol.2018181131
                30179109
                591da68b-a858-4359-99a1-0b118a796584
                © 2018
                History

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