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Algorithm to rule out clinically significant portal hypertension combining Shear-wave elastography of liver and spleen: a prospective multicentre study
  1. Christian Jansen1,
  2. Christopher Bogs1,
  3. Wim Verlinden2,
  4. Maja Thiele3,
  5. Philipp Möller1,
  6. Jan Görtzen1,
  7. Jennifer Lehmann1,
  8. Michael Praktiknjo1,
  9. Johannes Chang1,
  10. Aleksander Krag3,
  11. Christian P Strassburg1,
  12. Sven Francque2,
  13. Jonel Trebicka1,3
  1. 1 Department of Internal Medicine I, University of Bonn, Bonn, Germany
  2. 2 Department of Gastroenterology and Hepatology, University Hospital Antwerp, Edegem, Belgium
  3. 3 Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
  1. Correspondence to Professor Jonel Trebicka, Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, Bonn D-53105, Germany; jonel.trebicka{at}ukb.uni-bonn.de

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Recently, the UK guidelines on variceal bleeding1 and other reports have introduced the role of elastography for the diagnosis of oesophageal varices (OVs).2 ,3 Development of OVs is likely when the hepatic venous pressure gradient is higher than 10 mm Hg, which defines clinically significant portal hypertension (CSPH). Baveno VI implemented transient elastography (TE) as a tool to rule in CSPH in viral aetiologies and to rule out varices (need of screening endoscopy for varices).4 Furthermore, CSPH has a strong prognostic value in patients with cirrhosis.

Recent studies introduced Shear-wave elastography of the liver (L-SWE) as a promising tool to diagnose portal hypertension. These studies find good diagnostic accuracy of L-SWE with specificity and sensitivity ranging around 80% and superior to TE. However, in more than 30% of the patients CSPH could not be ruled in or ruled out, since their SWE values were between the cut-offs.

This prospective multicentre study investigated the …

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