摘要
BACKGROUND Portal pressure is of great significance in the treatment of hepatocellular carcinoma(HCC),but direct measurement is complicated and costly;thus,noninvasive measurement methods are urgently needed.AIM To investigate whether ultrasonography(US)-based portal pressure assessment could replace invasive transjugular measurement.METHODS A cohort of 102 patients with HCC was selected(mean age:54±13 years,male/female:65/37).Pre-operative US parameters were assessed by two independent investigators,and multivariate logistic analysis and linear regression analysis were conducted to develop a predictive formula for the portal pressure gradient(PPG).The estimated PPG predictors were compared with the transjugular PPG measurements.Validation was conducted on another cohort of 20 non-surgical patients.RESULTS The mean PPG was 17.32±1.97 mmHg.Univariate analysis identified the association of the following four parameters with PPG:Spleen volume,portal vein diameter,portal vein velocity(PVV),and portal blood flow(PBF).Multiple linear regression analysis was performed,and the predictive formula using the PVV and PBF was as follows:PPG score=19.336-0.312×PVV(cm/s)+0.001×PBF(mL/min).The PPG score was confirmed to have good accuracy with an area under the curve(AUC)of 0.75(0.68-0.81)in training patients.The formula was also accurate in the validation patients with an AUC of 0.820(0.53-0.83).CONCLUSION The formula based on ultrasonographic Doppler flow parameters shows a significant correlation with invasive PPG and,if further confirmed by prospective validation,may replace the invasive transjugular assessment.
基金
Supported by Beijing Municipal Science and Technology Commission,No.Z181100001718097
and the Capital Health Development Scientific Research Project,No.2018-1-2081.
