Value of liver stiffness measured by acoustic radiation force impulse in predicting portal hypertension in patients with decompensated hepatitis B cirrhosis

Abstract

Abstract: Objective To evaluate the diagnostic efficacy of liver stiffness (LS) measured by acoustic radiation force impulse (ARFI) in noninvasive prediction of portal hypertension (PH) in patients with decompensated hepatitis B cirrhosis. Methods Between April 2013 and June 2023, 74 patients with decompensated hepatitis B cirrhosis who received the measurement of hepatic venous pressure gradient (HVPG) and ARFI at the Second People′s Hospital of Lianyungang City from April 2013 to June 2023 were selected, including 53 males and 21 females, with an age of (56.0±13.2) years. According to the previous literature, the patients were divided into significant PH group (HVPG≥10 mmHg) and non-significant PH group (HVPG<10 mmHg). The clinical data of the two groups were compared, and the predictive efficacy of LSM, portal and splenic vein width and HVPG for significant PH and bleeding was analyzed. Results Among 74 patients, the significant and non-significant PH were 49 and 25 respectively. The ascites, WBC, INR, LSM, portal vein width, splenic vein width, HVPG and Child-Pugh score in the significant PH group were 16 cases (64.0%), (9.4±0.7) ×10⁹/L, (1.4±0.2), (2.3±0.7) m/s, (1.8±0.3) cm, (1.2±0.3), (12.7±2.0) mmHg and (7.3±1.7) points, which were significantly higher than those in the non-significant PH group [13 cases (26.5%), (5.9±0.5) ×10⁹/L, (1.1±0.3), (1.8±0.5) m/s, (1.5±0.3) cm, (0.9±0.2) cm and (8.9±1.1) mmHg, P<0.05]. After a six-month follow-up, 17 cases of 74 patients occured esophageal and gastric varices bleeding. LSM, width of portal and splenic vein and HVPG in the bleeding group were (2.4±0.8) m/s, (1.8±0.5) cm, (1.3±0.4) cm and (14.3±2.3) mmHg, which were significantly higher than those in the non-bleeding group [(1.7±0.7) m/s, (1.5±0.3) cm, (0.9±0.2) cm and (8.9±1.1) mmHg, P<0.05]. We respectively evaluated the diagnostic efficacy of the LSM, portal vein width, splenic vein width, and HVPG for significant PH using receiver operating characteristic (ROC) curve. The ROC curve showed that LSM, portal vein width and HVPG were ideal for diagnosis, and the area under the curve (AUC) of LSM was significantly higher than portal vein width and HVPG (P<0.05). Similarly, ROC curves were used to test the diagnostic efficacy of LSM, portal vein width, splenic vein width, and HVPG for bleeding (occurrence/non occurrence). The AUC value of LSM was significantly higher than the width of portal vein and HVPG (P<0.05). Conclusion In patients with decompensated cirrhosis, LSM detected by ARFI has certain value in the diagnosis of significant PH, which is worth popularizing in clinical practice.

Key words: Decompensated hepatitis B cirrhosis, Acoustic radiation force impulse, Liver stiffness, Portal hypertension

MIAO Li, ZHU Min-min, LI Wei, WANG Xian. Value of liver stiffness measured by acoustic radiation force impulse in predicting portal hypertension in patients with decompensated hepatitis B cirrhosis[J]. Chinese Hepatolgy, 2025, 30(8): 1080-1083.

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