Ultrasound in the Non-Invasive Evaluation of Fibrosis and Portal Hypertension
Annalisa Berzigotti MD
Researcher Specialist
Hepatic Haemodynamic Laboratory, Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
Ultrasound Section, Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorMarco Zoli MD, Professor of Medicine
Department of Internal Medicine, Ageing and Nephrology, University of Bologna, Italy
Search for more papers by this authorConcepción Bru Saumell MD
Professor of Radiology Senior Consultant
University of Barcelona, Ultrasound Section, Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorRosa Gilabert Sole MD
Chief
Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorAnnalisa Berzigotti MD
Researcher Specialist
Hepatic Haemodynamic Laboratory, Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
Ultrasound Section, Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorMarco Zoli MD, Professor of Medicine
Department of Internal Medicine, Ageing and Nephrology, University of Bologna, Italy
Search for more papers by this authorConcepción Bru Saumell MD
Professor of Radiology Senior Consultant
University of Barcelona, Ultrasound Section, Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorRosa Gilabert Sole MD
Chief
Centre Diagnostic per la Imatge, Hospital Clinic, Barcelona, Spain
Search for more papers by this authorRoberto de Franchis MD, AGAF
Professor of Gastroenterology Head
Department of Medical Sciences, University of Milan, and Gastroenterology 3 Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Mangiagalli and Regina Elena Foundation, Milan, Italy
Search for more papers by this authorSummary
This chapter contains sections titled:
-
Introduction
-
Diagnosis and staging of fibrosis
-
Diagnosis of cirrhosis
-
Classification, diagnosis and quantification of portal hypertension
-
Prediction of prognosis in cirrhosis
-
New US technologies and future applications
-
References
References
- Nicolau C, Bianchi L, Vilana R (2002) Gray-scale ultrasound in hepatic cirrhosis and chronic hepatitis: diagnosis, screening, and intervention. Semin Ultrasound CT MR 23: 3–18.
- Goyal N, Jain N, Rachapalli V, et al. (2009) Non-invasive evaluation of liver cirrhosis using ultrasound. Clin Radiol 64: 1056–66.
- Gaiani S, Gramantieri L, Venturoli N, et al. (1997) What is the criterion for differentiating chronic hepatitis from compensated cirrhosis? A prospective study comparing ultrasonography and percutaneous liver biopsy. J Hepatol 27: 979–85.
- Staub F, Tournoux-Facon C, Roumy J, et al. (2009) Liver fibrosis staging with contrast-enhanced ultrasonography: prospective multicenter study compared with METAVIR scoring. Eur Radiol 19: 1991–7.
- Sackett DL, Haynes BR, Guyatt GH, Tugwell P (1991) The interpretation of diagnostic data. In: Sackett DL, Haynes BR, Tugwell P, Guyatt GH (eds) Clinical Epidemiology: A basic science for clinical medicine ( 2nd ed.). Lippincott Williams & Wilkins Publishers: Boston, MA, pp. 69–152.
- Colli A, Fraquelli M, Andreoletti M, et al. (2003) Severe liver fibrosis or cirrhosis: accuracy of US fordetection. Radiology 227: 89–94.
- Jha P, Poder L, Wang ZJ, et al. (2010) Radiologic mimics of cirrhosis. AJR Am J Roentgenol 194: 993–9.
- Berzigotti A, Abraldes JG, Tandon P, et al. (2010) Ultrasonographic evaluation of liver surface and transient elastography in clinically doubtful cirrhosis. J Hepatol 52: 846–53.
- Bosch J, García-Pagán JC, Berzigotti A, et al. (2006) Measurement of portal pressure and its role in the management of chronic liver disease. Semin Liver Dis 26: 348–62.
- Nompleggi DJ, Farraye FA, Singer A, et al. (1991) Hepatic schistosomiasis: report of two cases and literature review. Am J Gastroenterol 86: 1658–64.
- Hashiguchi M, Okamura T, Yoshimoto K, et al. (2005) Demonstration of reversed flow in segmental branches of the portal vein with hand-held color Doppler ultrasonography after hematopoietic stem cell transplantation. Bone Marrow Transplant 36: 1071–5.
- Faughnan ME, Palda VA, Garcia-Tsao G, et al. (2009) International Guidelines for the Diagnosis and Management of Hereditary Hemorrhagic Telangiectasia. J Med Genet Jun29[Epub a head of print].
- Vilgrain V, Lebrec D, Menu Y, et al. (1990) Comparison between ultrasono-graphic signs and the degree of portal hypertension in patients with cirrhosis. Gastrointest Radiol 15: 218–22.
- Berzigotti A, Gilabert R, Abraldes JG, et al. (2008) Noninvasive prediction of clinically significant portal hypertension and esophageal varices in patients with compensated liver cirrhosis. Am J Gastroenterol 103: 1159–67.
- Robinson KA, Middleton WD, Al-Sukaiti R, et al. (2009) Doppler sonography of portal hypertension. Ultrasound Q 25: 3–13.
- Bolondi L, Gandolfi L, Arienti V, et al. (1982) Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration. Radiology 142: 167–72.
- Gaiani S, Bolondi L, Li Bassi S, et al. (1991) Prevalence of spontaneous hepatofugal portal flow in liver cirrhosis. Clinical and endoscopic correlation in 228 patients. Gastroenterology 100: 160–7.
- Sabba C, Merkel C, Zoli M, et al. (1995) Interobserver and interequipment variability of echo-Doppler examination of the portal vein: effect of a cooperative training program. Hepatology 21: 428–33.
- Zoli M, Marchesini G, Cordiani MR, et al. (1986) Echo-Doppler measurement of splanchnic blood flow in control and cirrhotic subjects. J Clin Ultrasound 14: 429–35.
- Bolognesi M, Sacerdoti D, Merkel C, et al. (1995) Relationship between portal blood flow measured by image-directed Doppler ultrasonography and hepatic blood flow measured by indocyanine green constant infusion in patients with cirrhosis. J Clin Ultrasound 23: 297–303.
- Kok T, van der Jagt EJ, Haagsma EB, et al. (1999) The value of Doppler ultrasound in cirrhosis and portal hypertension. Scand J Gastroenterol Suppl 230: 82–8.
- Sgouros SN, Vasiliadis KV, Pereira SP (2009). Systematic review: endoscopic and imaging-based techniques in the assessment of portal haemodynamics and the risk of variceal bleeding. Aliment Pharmacol Ther 30: 965–76.
- Bolognesi M, Sacerdoti D, Merkel C, et al. (2001) Noninvasive grading of the severity of portal hypertension in cirrhotic patients by echo-color-Doppler. Ultrasound Med Biol 27: 901–7.
- Berzigotti A, Schepis F, García-Pagán JC. (2007) Monitoring treatment of cirrhosis and portal hypertension: non-invasive means. In: Arroyo V, Sanchez-Fueyo A, Fernandez-Gomez J, et al. (eds) Advances in the Therapy of Liver Diseases ( 1st ed.). Ars Medica: Barcelona, pp. 39–52.
- Iwao T, Oho K, Sakai T, et al. (1998) Noninvasive hemodynamic measurements of superior mesenteric artery in the prediction of portal pressure response to propranolol. J Hepatol 28: 847–55.
- Schepke M, Raab P, Hoppe A, et al. (2000) Comparison of portal vein velocity and the hepatic venous pressure gradient in assessing the acute portal hemo-dynamic response to propranolol in patients with cirrhosis. Am J Gastroenterol 95: 2905–9.
- Abraldes JG, Gilabert R, Turnes J, et al. (2005) Utility of color Doppler ultra-sonography predicting tips dysfunction. Am J Gastroenterol 100: 2696–701.
- de Franchis R. (2008) Non-invasive (and minimally invasive) diagnosis of oesophageal varices. JHepatol 49: 520–7.
- Berzigotti A, Merkel C, Magalotti D, et al. (2008) New abdominal collaterals at ultrasound: a clue of progression of portal hypertension. Dig Liver Dis 40: 62–7.
- Berzigotti A, Zappoli P, Magalotti D, et al. (2008) Spleen enlargement on follow-up evaluation: a noninvasive predictor of complications of portal hypertension in cirrhosis. Clin Gastroenterol Hepatol 6: 1129–34.
- Siringo S, Bolondi L, Gaiani S, et al. (1994) Timing of the first variceal hemorrhage in cirrhotic patients: prospective evaluation of Doppler flowmetry, endoscopy and clinical parameters. Hepatology 20: 66–73.
- Zocco MA, Di SE, De CR, et al. (2009) Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development. JHepatol 51: 682–9.
- Tarantino G, Citro V, Conca P, et al. (2009) What are the implications of the spontaneous spleno-renal shunts in liver cirrhosis? BMC Gastroenterol 9: 89.
- Maroto A, Gines A, Salo J, et al. (1994) Diagnosis of functional kidney failure of cirrhosis with Doppler sonography: prognostic value of resistive index. Hepatology 20: 839–44.
- Friedrich-Rust M, Wunder K, Kriener S, et al. (2009) Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 252: 595–604.
- Wilson SR, Gupta C, Eliasziw M, et al. (2009) Volume imaging in the abdomen with ultrasound: how we do it. AJR Am J Roentgenol 193: 79–85.