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Diagnosing Portal Hypertension with Noninvasive Subharmonic Pressure Estimates from a US Contrast Agent
Journal article   Open access   Peer reviewed

Diagnosing Portal Hypertension with Noninvasive Subharmonic Pressure Estimates from a US Contrast Agent

Ipshita Gupta, John R. Eisenbrey, Priscilla Machado, Maria Stanczak, Corinne E. Wessner, Colette M. Shaw, Sriharsha Gummadi, Jonathan M. Fenkel, Alison Tan, Cynthia Miller, …
Radiology, v 298(1)
01 Jan 2021
DOI: https://doi.org/10.1148/radiol.2020202677
PMID: 33201789
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771992View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology
Background: The current standard for assessing the severity of portal hypertension is the invasive acquisition of hepatic venous pressure gradient (HVPG). A noninvasive US-based technique called subharmonic-aided pressure estimation (SHAPE) could reduce risk and enable routine acquisition of these pressure estimates. Purpose: To compare quantitative SHAPE to HVPG measurements to diagnose portal hypertension in participants undergoing a transjugular liver biopsy. Materials and Methods: This was a prospective cross-sectional trial conducted at two hospitals between April 2015 and March 2019 (ClinicalTrials.gov identifier, NCT02489045). This trial enrolled participants who were scheduled for transjugular liver biopsy. After standard-of-care transjugular liver biopsy and HVPG pressure measurements, participants received an infusion of a US contrast agent and saline. During infusion, SHAPE data were collected from a portal vein and a hepatic vein, and the difference was compared with HVPG measurements. Correlations between data sets were determined by using the Pearson correlation coefficient, and statistical significance between groups was determined by using the Student t test. Receiver operating characteristic analysis was performed to determine the sensitivity and specificity of SHAPE. Results: A total of 125 participants (mean age 6 standard deviation, 59 years 6 12; 80 men) with complete data were included. Participants at increased risk for variceal hemorrhage (HVPG.12 mm Hg) had a higher mean SHAPE gradient compared with participants with lower HVPGs (0.79 dB 6 2.53 vs 24.95 dB 6 3.44; P,.001), which is equivalent to a sensitivity of 90% (13 of 14; 95% CI: 88, 94) and a specificity of 80% (79 of 99; 95% CI: 76, 84). The SHAPE gradient between the portal and hepatic veins was in good overall agreement with the HVPG measurements (r = 0.68). Conclusion: Subharmonic-aided pressure estimation is an accurate noninvasive technique for detecting clinically significant portal hypertension. (C) RSNA, 2020.

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70 citations in Web of Science
62 citations in Scopus

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Collaboration types
Industry collaboration
Domestic collaboration
Web of Science research areas
Radiology, Nuclear Medicine & Medical Imaging
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