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Virtual portal pressure gradient from anatomic CT angiography
  1. Xiaolong Qi1,
  2. Zhiwei Li2,
  3. Jiale Huang1,
  4. Yanjie Zhu1,
  5. Hao Liu3,
  6. Fangyu Zhou1,
  7. Changchun Liu2,
  8. Chaohui Xiao2,
  9. Jinghui Dong2,
  10. Yongzhao Zhao1,
  11. Mingxin Xu1,
  12. Surong Xing4,
  13. Weiguo Xu4,
  14. Changqing Yang1
  1. 1Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
  2. 2Department of Hepatobiliary Surgery, 302 Hospital of Chinese People's Liberation Army, Beijing, China
  3. 3Biology and Biomedical Sciences, Harvard Medical School, Boston, Massachusetts, USA
  4. 4Division of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
  1. Correspondence to Professor Changqing Yang, Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 389 XinCun Road, Shanghai 200065, China; cqyang{at}tongji.edu.cn

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By definition, portal hypertension means pathological elevation of the portal pressure gradient (PPG), the direct measurement of which is extremely invasive. This has prompted the use of the less invasive hepatic venous pressure gradient (HVPG), widely accepted as the PPG equivalent.1–3 In a recent article in Gut, HVPG was used as the only criterion to assess haemodynamic response (reduction in HVPG of ≥20% or to values <12 mm Hg) rates to carvedilol in propranolol non-responders.1 Although accurate, HVPG is still invasive, and thus not routinely performed in all centres.2 ,3 As HVPG becomes standard practice, repeated invasive measurement has stimulated the search for non-invasive techniques to measure PPG.3–5 Here, we present a virtual PPG (vPPG) based on CT angiography and Doppler ultrasound.

The VIRGIN Study was a multicentre, blinded, prospective, analytical trial carried out at Tongji Hospital, Shanghai and 302 Hospital, Beijing. The study was …

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