Accuracy and influencing factors of hepatic venous pressure gradient, spleen stiffness and liver stiffness in the detection of portal hypertension with liver cirrhosis.

Abstract

PurposeTo assess the accuracy of hepatic venous pressure gradient (HVPG), spleen stiffness (SS) and liver stiffness (LS) for detecting portal hypertension (PH).MethodsWe measured HVPG, SS, LS and portal pressure gradient (PPG) in 104 patients with liver cirrhosis from April 2019 to April 2024. Correlations between these parameters and PH were analyzed using Pearson correlation or Spearman's rank correlation test appropriate. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis. Multiple linear regression analysis was to identify factors independently associated with HVPG, SS and LS.ResultsHVPG and SS were significantly correlated with PPG (p < 0.005), whereas LS showed no significant correlation with PPG (p = 0.532). For prediction of PH defined by PPG≥12, 20 and 25 mmHg, areas under the ROC curve (AUC) of HVPG were 0.983, 0.875 and 0.680, and the AUC of SS were 0.764, 0.922 and 0.700, respectively. Multiple linear regression analysis showed that factors independently associated with HVPG included aspartate aminotransferase (AST), total bilirubin (TBIL) and previous bleeding, while those associated with SS were white blood cell count (WBC) and Model for End-Stage Liver Disease-Sodium (MELD-Na) score.ConclusionHVPG and SS had favorable diagnostic performance for identifying PH in patients with liver cirrhosis.