Non-invasive assessment of portal vein pressure in complicated portal hypertension

Aim. To develop a non-invasive, accurate, and simple method for determining portal vein pressure in patients with cirrhosis-related portal hypertension.

Materials and Methods. In 72 patients with complicated portal hypertension, the relationship between portal pressure and liver and spleen stiffness was examined. Exact portal vein pressure was  obtained by direct manometry during TIPS. Liver and spleen stiffness were measured using elastometry. The number of spontaneous portosystemic shunts detected on CT was also taken into account.

Results. A direct relationship was identified between the severity of portal hypertension and the values of liver and spleen elastometry, adjusted for the number of spontaneous portosystemic shunts detected on CT splenoportography. This enabled derivation of a simplified formula for calculating elevated portal vein pressure. The error of method was slightly above 5% compared with direct portomanometry.

Conclusion. The proposed non-invasive method is accurate, easy to perform, and suitable for clinical use.

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