Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis.

Autor: Gioia S; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: stensgioia@hotmail.com., De Santis A; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy., d'Amati G; Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy., Nardelli S; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy., Spagnoli A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy., Rocco AD; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy., Ridola L; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy., Riggio O; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Jazyk: angličtina
Zdroj: Hepatobiliary & pancreatic diseases international : HBPD INT [Hepatobiliary Pancreat Dis Int] 2024 Feb; Vol. 23 (1), pp. 20-24. Date of Electronic Publication: 2023 Jul 09.
DOI: 10.1016/j.hbpd.2023.07.001
Abstrakt: Background: Porto-sinusoidal vascular disease (PSVD) and portal vein thrombosis (PVT) are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal system. As PVT may be a consequence of PSVD, in PVT patients at presentation, a pre-existing PSVD should be suspected. In these patients the identification of an underlying PSVD would have relevant implication regarding follow-up and therapeutic management, but it could be challenging. In this setting ultrasonography may be valuable in differential diagnosis. The aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and "pure" PVT and then to suspect PVT secondary to a pre-existing PSVD.
Methods: Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse (ARFI).
Results: ARFI was higher and superior mesenteric vein (SMV) diameter was wider in PSVD patients than in PVT patients. Thus, a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT (the area under the curve = 0.780; 95% confidence interval: 0.690-0.869).
Conclusions: A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.
Competing Interests: Competing interest No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
(Copyright © 2023 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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