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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 …
CJ, CB, SF and JT have contributed equally.
Contributors The study was designed by JT. Data were obtained by CB, CJ, WV, MT, PM, JG, JL, MP, JC, AK, CPS SF and JT. The report was written by CB, CJ, AK, SF and JT. All authors approved the final version.
Funding This study was supported by grants from the Deutsche Forschungsgemeinschaft (SFB TRR57 to P18), the H. J. & W. Hector Stiftung, Ernst-Bertha-Grimmke-Stiftung (6/15) and European Union's Horizon 2020 research and innovation programme (No 668031).
Competing interests None declared.
Ethics approval Ethics committee of the University of Bonn (Nr. 121/14); ethics committee of the university of Antwerp (15/13/135); ethics committee of the university Odense (51872).
Provenance and peer review Not commissioned; internally peer reviewed.
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