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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. 1 Division of Gastroenterology a nd Hepatology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
  2. 2 Department of Hepatobiliary Surgery, 302 Hospital of Chinese People's Liberation Army, Beijing, China
  3. 3 Biology and Biomedical Sciences, Harvard Medical School, Boston, Massachusetts, USA
  4. 4 Division 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

https://doi.org/10.1136/gutjnl-2014-308543

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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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    Footnotes

    • XQ and ZL contributed equally.

    • Contributors CY and ZL offered administrative and material support and obtained funding; XQ, CY and ZL designed the study; XQ and HL drafted and revised the manuscript; CL, CX and JD acquired the data; JH, YZ, FZ and YZha analysed data; MX, SX and WX interpreted the results. They all participated sufficiently in the work and all approved the final version of the article.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics committees of Tongji Hospital of Tongji University, Shanghai, China and 302 Hospital of Chinese People's Liberation Army, Beijing, China.

    • Provenance and peer review Not commissioned; externally peer reviewed.