Comparison of the diagnostic efficacy between virtual portal pressure gradient and hepatic venous pressure gradient in patients with cirrhotic portal hypertension

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases Pub Date : 2024-12-26 DOI:10.1111/1751-2980.13319

Wei Ping Song, Shuo Zhang, Jing Li, Yu Yang Shao, Ji Chong Xu, Chang Qing Yang

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Abstract

Objectives

This study aimed to evaluate the performance of virtual portal pressure gradient (vPPG) and its associated hemodynamic parameters of 3-dimensional (3D) model in patients with cirrhosis.

Methods

Seventy cirrhotic patients who underwent both hepatic venous pressure gradient (HVPG) measurement and vPPG calculation were prospectively collected. The ideal-state model (ISM; n = 44) was defined by sinusoidal PH without hepatic vein shunt or portal vein thrombosis, whereas those not conforming to the criteria were classified as non-ISM (n = 26). Correlation analyses were conducted to determine the relationship between vPPG or its associated 3D hemodynamic parameters and HVPG. The diagnostic and predictive performance of vPPG and HVPG for cirrhotic-related complications was evaluated using the receiver operating characteristic (ROC) curve and Kaplan–Meier analysis.

Results

In the ISM group, vPPG-associated hemodynamic parameters including total branch cross-sectional area (S2), average branch cross-sectional area (S), and average portal vein model length (h) were correlated with HVPG (r = 0.592, 0.536, −0.497; all p < 0.001), whereas vPPG was strongly correlated with HVPG (r = 0.832, p < 0.001). In the non-ISM group, vPPG, S2, S, and h were not related to HVPG (all p > 0.05). In the ISM group, both vPPG and HVPG showed significant diagnostic and predictive capabilities for cirrhosis-related complications. While in the non-ISM group, the diagnostic accuracy and predictive efficacy of vPPG surpassed those of HVPG.

Conclusion

HVPG exhibited superior diagnostic and predictive efficacy for cirrhotic PH in the ISM, whereas vPPG showed enhanced performance in non-ISM.

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虚门脉压梯度与肝静脉压梯度对肝硬化门脉高压诊断效果的比较。

目的：本研究旨在评价三维（3D）模型虚拟门静脉压力梯度（vPPG）在肝硬化患者中的表现及其相关血流动力学参数。方法：前瞻性收集70例肝硬化患者进行肝静脉压梯度（HVPG）测量和vPPG计算。理想状态模型(ISM；n = 44)以PH值为正弦值，无肝静脉分流或门静脉血栓形成，不符合标准者为非ism （n = 26）。通过相关分析确定vPPG或其相关三维血流动力学参数与HVPG的关系。采用受试者工作特征（ROC）曲线和Kaplan-Meier分析评估vPPG和HVPG对肝硬化相关并发症的诊断和预测性能。结果：ISM组vppg相关血流动力学参数总分支横截面积（S2）、平均分支横截面积(S)、门静脉模型平均长度(h)与HVPG相关(r = 0.592, 0.536, -0.497；p < 0.05)。在ISM组中，vPPG和HVPG均显示出对肝硬化相关并发症的诊断和预测能力。而在非ism组，vPPG的诊断准确性和预测效果优于HVPG。结论：HVPG在ISM中对肝硬化PH具有优越的诊断和预测功效，而vPPG在非ISM中表现出更强的性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Digestive Diseases 医学-胃肠肝病学

CiteScore

5.40

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.