Non invasive evaluation of portal hypertension using ultrasound elastography.

Berzigotti A, , et al.

Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Switzerland. Electronic address:

Journal of hepatology. Feb 2017.

Portal hypertension (PH) leads to serious complications such as bleeding from gastro-esophageal varices, ascites and porto-systemic encephalopathy in patients with chronic liver disease (CLD). Since the gold-standard methods for assessing PH and its complications (measurement of hepatic venous pressure gradient, HVPG; endoscopy), are invasive expensive and not available at all centers, non-invasive methods have been increasingly investigated in the last 20 years. The present review focuses on the role of ultrasound elastography, a novel group of non-invasive techniques able to measure stiffness in target organs, to identify the presence, severity and risk of complications of PH. The rationale, accumulated evidence, advantages and limitations of liver and spleen stiffness measurements evaluated by different ultrasound elastography techniques in patients with advanced CLD is discussed. Recent data regarding the use of ultrasound elastography techniques in non-cirrhotic forms of PH is also described.