Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis
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 use...
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Korean Association for the Study of the Liver
2017-03-01
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doaj-46dc8471012241ebb258f90a7c2f32cf2020-11-24T20:59:53ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2017-03-01231344110.3350/cmh.2016.00591337Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysisGaeun Kim0Moon Young Kim1Soon Koo Baik2 Research Institute for Nursing Science, College of Nursing, Keimyung University, Daegu, Korea Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, KoreaBackground/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.http://e-cmh.org/upload/pdf/cmh-2016-0059.pdfElastographyHypertension, PortalLiver cirrhosisReview, SystematicMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gaeun Kim Moon Young Kim Soon Koo Baik |
spellingShingle |
Gaeun Kim Moon Young Kim Soon Koo Baik Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis Clinical and Molecular Hepatology Elastography Hypertension, Portal Liver cirrhosis Review, Systematic Meta-analysis |
author_facet |
Gaeun Kim Moon Young Kim Soon Koo Baik |
author_sort |
Gaeun Kim |
title |
Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
title_short |
Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
title_full |
Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
title_fullStr |
Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
title_full_unstemmed |
Transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
title_sort |
transient elastography versus hepatic venous pressure gradient for diagnosing portal hypertension: a systematic review and meta-analysis |
publisher |
Korean Association for the Study of the Liver |
series |
Clinical and Molecular Hepatology |
issn |
2287-2728 2287-285X |
publishDate |
2017-03-01 |
description |
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. |
topic |
Elastography Hypertension, Portal Liver cirrhosis Review, Systematic Meta-analysis |
url |
http://e-cmh.org/upload/pdf/cmh-2016-0059.pdf |
work_keys_str_mv |
AT gaeunkim transientelastographyversushepaticvenouspressuregradientfordiagnosingportalhypertensionasystematicreviewandmetaanalysis AT moonyoungkim transientelastographyversushepaticvenouspressuregradientfordiagnosingportalhypertensionasystematicreviewandmetaanalysis AT soonkoobaik transientelastographyversushepaticvenouspressuregradientfordiagnosingportalhypertensionasystematicreviewandmetaanalysis |
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