Diagnosis of Clinically Significant Portal Hypertension Using CT- and MRI-based Vascular Model

作者：Chengyan Wang, Yifei Huang, Changchun Liu, Fuquan Liu, Xumei Hu, Xutong Kuang, Weimin An, Chuan Liu, Yanna Liu, Shanghao Liu, Ruiling He, He Wang, Xiaolong Qi · 发表于：Radiology · 年份：2023 · DOI：10.1148/radiol.221648 · 被引用次数：28 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis

Background Currently, the hepatic venous pressure gradient (HVPG) remains the reference standard for diagnosis of clinically significant portal hypertension (CSPH) but is limited by its invasiveness and availability. Purpose To investigate a vascular geometric model for noninvasive diagnosis of CSPH (HVPG ≥10 mm Hg) in patients with liver cirrhosis for both contrast-enhanced CT and MRI. Materials and Methods In this retrospective study, consecutive patients with liver cirrhosis who underwent HVPG measurement from August 2016 to April 2019 were included. Patients without hepatic diseases were included and marked as non-CSPH to balance the ratio of CSPH 1:1. A variety of vascular parameters were extracted from the portal vein, hepatic vein, aorta, and inferior vena cava and then entered into a vascular geometric model for identification of CSPH. Diagnostic performance was assessed with the area under the receiver operating characteristic curve (AUC). Results The model was developed and tested with retrospective data from 250 patients with liver cirrhosis and 273 patients without clinical evidence of hepatic disease at contrast-enhanced CT examination, including 213 patients with CSPH (mean age, 49 years ± 12 [SD]; 138 women) and 310 patients without CSPH (mean age, 50 years ± 9; 177 women). For external validation, an MRI data set with 224 patients with cirrhosis (mean age, 49 years ± 10; 158 women) and a CT data set with 106 patients with cirrhosis (mean age, 53 years ± 12; 71...