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Hepatic venous pressure gradient correlates with advanced hepatic fibrosis: a retrospective review.

Purpose: To determine if hepatic venous pressure gradient (HVPG) correlates with advanced hepatic fibrosis, as a complement to transjugular (transvenous) core needle liver biopsy. Materials and methods: After institutional review board approval, a retrospective review was conducted on 340 patients w...

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Published in:Abdominal Radiology Vol. 42; no. 11; pp. 2609 - 2615
Main Authors: Vincent, Jonathan, Stark, Christopher, Shields, Joseph, Bhave, Anant, Morris, Christopher
Format: Journal Article
Published: Springer Nature Nov2017
Online Access:View this record in EBSCOhost
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      dt: Nov2017
      vid: 42
      iid: 11
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      pub: Springer Nature
      place: New York, New York
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        144024562
        10.1007/s00261-017-1171-y
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        atl: Hepatic venous pressure gradient correlates with advanced hepatic fibrosis: a retrospective review.
      aug:
        au:
          Vincent, Jonathan
          Stark, Christopher
          Shields, Joseph
          Bhave, Anant
          Morris, Christopher
        affil: Department of Radiology , Beth Israel Deaconess Plymouth Hospital , Plymouth USA
      sug:
      ab: Purpose: To determine if hepatic venous pressure gradient (HVPG) correlates with advanced hepatic fibrosis, as a complement to transjugular (transvenous) core needle liver biopsy. Materials and methods: After institutional review board approval, a retrospective review was conducted on 340 patients who underwent transjugular (transvenous) core needle liver biopsy with concurrent pressure measurements between 6/1/2007 and 6/1/2013. Spearman correlation and linear regression were performed. A receiver operating characteristic (ROC) curve was created and sensitivity, specificity, predictive values and likelihood ratios were calculated. Results: Indications included hepatitis C, abnormal liver function tests, non-alcoholic steatohepatitis, autoimmune hepatitis, and cirrhosis, among others. Biopsies showed stage 1 or 2 fibrosis in 15.6% each, stage 3 fibrosis in 21.6%, stage 4 fibrosis in 40.7%, and no fibrosis in 6.5%. Mean HVPG was 6.5 mm Hg (SD 5.0) with a range of 0-26 mm Hg. Spearman correlation coefficient for association between HVPG and fibrosis stage was 0.561 ( p < 0.001). R2 on linear regression was 0.247 ( p < 0.001). ROC curve for the prediction of stage 4 fibrosis had an area under the curve of 0.79 (95% CI 0.73-0.85). HVPG of ≥6 mm Hg had a sensitivity of 71.3%, specificity of 79.6%, positive predictive value of 70.5%, negative predictive value of 80.2%, positive likelihood ratio of 3.49 (95% CI 2.45-4.97) and negative likelihood ratio of 0.36 (95% CI 0.26-0.50) for diagnosis of stage 4 fibrosis. Conclusions: HVPG correlates with stage 4 (advanced) hepatic fibrosis.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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