Liver stiffness by transient elastography to detect porto-sinusoidal vascular liver disease with portal hypertension
Laure Elkrief
(1, 2, 3)
,
Marie Lazareth
(3)
,
Sylvie Chevret
(4)
,
Valerie Paradis
(5, 6)
,
Marta Magaz
(7)
,
Lorraine Blaise
(8)
,
Laura Rubbia-Brandt
(1)
,
Lucile Moga
(3)
,
Francois Durand
(3)
,
Audrey Payance
(3)
,
Aurelie Plessier
(3)
,
Cendrine Chaffaut
(9)
,
Dominique Valla
(5)
,
Marion Malphettes
(10)
,
Alba Diaz
(11)
,
Jean-Charles Nault
(8, 12, 13)
,
Pierre Nahon
(14, 8, 12)
,
Etienne Audureau
(15)
,
Vlad Ratziu
(16)
,
Laurent Castera
(5)
,
Juan-Carlos Garcia Pagan
(11)
,
Nathalie Ganne-Carrie
(8, 12, 13)
,
Pierre-Emmanuel Rautou
(5)
1
HUG -
Hôpitaux Universitaires de Genève
2 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
3 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
4 SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA)
5 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
6 Service d'Anatomo-Pathologie
7 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
8 Hôpital Jean Verdier [AP-HP]
9 SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA)
10 AP-HP - Hopital Saint-Louis [AP-HP]
11 Clinic Barcelona Hospital Universitari
12 Equipe labellisée Ligue contre le Cancer
13 FunGeST - Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC]
14 U1162 - Génomique Fonctionnelle des Tumeurs Solides
15 Hôpital Henri Mondor
16 CHU Pitié-Salpêtrière [AP-HP]
2 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
3 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
4 SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA)
5 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
6 Service d'Anatomo-Pathologie
7 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
8 Hôpital Jean Verdier [AP-HP]
9 SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA)
10 AP-HP - Hopital Saint-Louis [AP-HP]
11 Clinic Barcelona Hospital Universitari
12 Equipe labellisée Ligue contre le Cancer
13 FunGeST - Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC]
14 U1162 - Génomique Fonctionnelle des Tumeurs Solides
15 Hôpital Henri Mondor
16 CHU Pitié-Salpêtrière [AP-HP]
Résumé
OBJECTIVE: Porto-sinusoidal vascular liver disease (PSVD) is a rare cause of portal hypertension. PSVD is still often misdiagnosed as cirrhosis, emphasizing the need to improve PSVD diagnosis strategies. Data on liver stiffness measurement using transient elastography (TE-LSM) in PSVD are limited. The aim of this study was to evaluate the accuracy of TE-LSM to discriminate PSVD from cirrhosis in patients with signs of portal hypertension.
Retrospective multicenter study comparing TE-LSM in patients with PSVD, according to Vascular Liver Disease Interest Group criteria, with patients with compensated biopsy-proven cirrhosis associated with alcohol (n = 117), HCV infection (n = 110), or NAFLD (n = 46). All patients had at least one sign of portal hypertension among gastroesophageal varices, splenomegaly, portosystemic collaterals, history of ascites, or platelet count < 150 × 109
CONCLUSIONS: This study including a total of 155 patients with PSVD and 273 patients with cirrhosis demonstrates that TE-LSM < 10 kPa strongly suggests PSVD in patients with signs of portal hypertension. Conversely, when TE-LSM is >20 kPa, PSVD is highly unlikely.