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Liver and Spleen Stiffness to Predict Portal Hypertension and Its Complications

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Liver Elastography

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Abstract

Portal hypertension is a common syndrome characterized by an increase in portal venous pressure driving life-threatening complications. In advanced chronic liver disease, increased portal venous pressure is one of the hallmarks of progression; in this scenario, portal hypertension is best diagnosed by the invasive measurement of hepatic venous pressure gradient (HVPG). In the last 10 years, ultrasound elastography techniques emerged as valuable non-invasive tools in the field of portal hypertension. It is now possible to identify patients with clinically significant portal hypertension and to guide the selection of patients requiring endoscopy to screen for varices at risk of bleeding using elastography techniques. In addition to liver stiffness measurement (LSM), spleen stiffness measurement (SSM) using transient elastography, point shear wave elastography, and 2D shear-wave elastography have been tested in this setting. This chapter provides an updated summary of the rationale and use of ultrasound elastography to diagnose, stage, and follow up portal hypertension and its complications.

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Acknowledgment

Yuly P. Mendoza is supported by the Swiss Government Excellence Scholarship ESKAS-Nr: 2018.0666; Susana G. Rodrigues receives financial support from the Stiftung für Leberkrankheiten Bern.

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Authors and Affiliations

  1. Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine (UVCM), Inselspital, University of Bern, Bern, Switzerland

    Yuly P. Mendoza, Giuseppe Murgia, Susana G. Rodrigues, Maria G. Delgado & Annalisa Berzigotti

  2. Department of Biomedical Research (DBMR), University of Bern, Bern, Switzerland

    Yuly P. Mendoza, Giuseppe Murgia, Susana G. Rodrigues, Maria G. Delgado & Annalisa Berzigotti

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  1. Yuly P. Mendoza
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  2. Giuseppe Murgia
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Correspondence to Annalisa Berzigotti .

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  1. Department of Medicine and Center for Alcohol Research and Liver Diseases, Salem Medical Center, University of Heidelberg, Heidelberg, Germany

    Sebastian Mueller

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Mendoza, Y.P., Murgia, G., Rodrigues, S.G., Delgado, M.G., Berzigotti, A. (2020). Liver and Spleen Stiffness to Predict Portal Hypertension and Its Complications. In: Mueller, S. (eds) Liver Elastography. Springer, Cham. https://doi.org/10.1007/978-3-030-40542-7_31

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