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Transient elastography versus hepatic venous pressure gradient in diagnosing portal hypertension : a systematic review and meta-analysis

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Author(s)
김가은
Alternative Author(s)
Kim, Ga Eun
Publication Year
2017
Keyword
ElastographyHypertensionPortalLiver cirrhosisReviewSystematicMeta-analysis
Abstract
Background/Aims :

Transient elastography (TE) has been proposed as a promising noninvasive alternative to hepatic venous pressure gradient (HVPG) for detecting portal hypertension (PH). However, previous studies have yielded conflicting results. We gathered evidence from literature on the clinical usefulness of TE versus HVPG for assessing PH.


Methods :

We conducted a systematic review by searching databases for relevant literature evaluating the clinical usefulness of non-invasive TE for assessing PH in patients with cirrhosis. A literature search in Ovid Medline, EMBASE and the Cochrane Library was performed for all studies published prior to December 30, 2015.


Results :

Eight studies (1,356 patients) met our inclusion criteria. For the detection of PH (HVPG ≥6 mmHg), the summary sensitivity and specificity were 0.88 (95% confidence interval [CI] 0.86-0.90) and 0.74 (95% CI 0.67-0.81), respectively. Regarding clinically significant PH (HVPG ≥10 mmHg), the summary sensitivity and specificity were 0.85 (95% CI 0.63-0.97) and 0.71 (95% CI 0.50-0.93), respectively. The overall correlation estimate of TE and HVPG was large (0.75, 95% CI: 0.65; 0.82, P<0.0001).


Conclusions :

TE showed high accuracy and correlation for detecting the severity of PH. Therefore, TE shows promise as a reliable and non-invasive procedure for the evaluation of PH that should be integrated into clinical practice.
Department
Dept. of Nursing (간호학)
Research Institute for Nursing Science (간호과학연구소)
Publisher
College of Nursing
Citation
Clinical and Molecular Hepatology, Vol.23(1) : 34-41, 2017
Type
Article
ISSN
2287-2728
DOI
10.3350/cmh.2016.0059
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/32394
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