Validation of Baveno VII criteria for clinically significant portal hypertension by two-dimensional shear wave elastography

Author:

He Ruiling1,Liu Chuan2,Grgurevic Ivica3,Guo Ying4,Xu Huixiong5,Liu Jiacheng6,Liu Yunfang4,Wang XiaoYan4,Shi Hongmei4,Madir Anita7,Podrug Kristian8,Zhu Yuli5,Hua Yongli4,Wang Kun4,Wen Jing4,Su Meiqin4,Zhang Qun2,Li Jie6,Qi Xiaolong2ORCID

Affiliation:

1. Lanzhou University First Affiliated Hospital: Lanzhou University First Hospital

2. Southeast University Zhongda Hospital

3. University of Zagreb School of Medicine: Sveuciliste u Zagrebu Medicinski fakultet

4. Third People's Hospital of Taiyuan

5. Zhongshan Hospital Fudan University

6. Nanjing Drum Tower Hospital: Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital

7. 4-University Hospital Dubrava

8. University Hospital Center Split

Abstract

Abstract Background: The Baveno VII consensus proposed criteria for the non-invasively diagnosis of clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease (cACLD). The performance of Baveno VII criteria for assessing CSPH by two-dimensional shear wave elastography (2D-SWE) had not been well validated. We aimed to validate the performance of Baveno VII criteria for rule-in and rule-out CSPH by 2D-SWE. Method: This is an international multicenter study including cACLD patients from China and Croatia with paired liver stiffness measurement (LSM), spleen stiffness measurement (SSM) by 2D-SWE, and hepatic venous pressure gradient (HVPG) were included. CSPH was defined as HVPG ≥ 10 mmHg. Result: A total of 146 patients with cACLD were enrolled, and finally 118 patients were included in the analysis. Among them, CSPH was documented in 79 (66.9%) patients. Applying the Baveno VII criteria for rule-out CSPH by 2D-SWE, [LSM ≤ 15 kPa and platelet count ≥ 150×109/L] OR SSM < 21 kPa, could exclude CSPH with sensitivity > 90% (93.5% or 98.7%) but negative predictive value < 90% (74.1% or 85.7%). Using the Baveno VII criteria for rule-in CSPH by 2D-SWE, LSM ≥ 25 kPa OR SSM ≥ 50 kPa, could diagnose CSPH with 100% specificity and 100% positive predictive values. Conclusion: Baveno VII criteria by 2D-SWE showed a good diagnostic performance for ruling in but not for ruling out CSPH, which might become an emerging non-invasive elastography tool to select the patients who needed non-selective beta blocker therapy.

Publisher

Research Square Platform LLC

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