Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy
Open Access
- 17 April 2017
- journal article
- review article
- Published by Oxford University Press (OUP) in Gastroenterology Report
- Vol. 5 (2), 79-89
- https://doi.org/10.1093/gastro/gox012
Abstract
The concept of ‘cirrhosis’ is evolving and it is now clear that compensated and decompensated cirrhosis are completely different in terms of prognosis. Furthermore, the term ‘advanced chronic liver disease (ACLD)’ better reflects the continuum of histological changes occurring in the liver, which continue to progress even after cirrhosis has developed, and might regress after removing the etiological factor causing the liver disease. In compensated ACLD, portal hypertension marks the progression to a stage with higher risk of clinical complication and requires an appropriate evaluation and treatment. Invasive tests to diagnose cirrhosis (liver biopsy) and portal hypertension (hepatic venous pressure gradient measurement and endoscopy) remain of crucial importance in several difficult clinical scenarios, but their need can be reduced by using different non-invasive tests in standard cases. Among non-invasive tests, the accepted use, major limitations and major benefits of serum markers of fibrosis, elastography and imaging methods are summarized in the present review.Keywords
This publication has 104 references indexed in Scilit:
- Magnetic resonance elastography of liver: Technique, analysis, and clinical applicationsJournal of Magnetic Resonance Imaging, 2013
- Ultraschall bei Pfortaderhochdruck – Teil 2 – und EFSUMB-Empfehlungen zur Durchführung und Dokumentation von Ultraschalluntersuchungen bei PfortaderhochdruckUltraschall in der Medizin - European Journal of Ultrasound, 2012
- Ultraschall bei Pfortaderhochdruck – Teil 1Ultraschall in der Medizin - European Journal of Ultrasound, 2011
- Liver biopsyJournal of Hepatology, 2008
- Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis CJournal of Hepatology, 2008
- Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver diseaseJournal of Hepatology, 2008
- Performance of Transient Elastography for the Staging of Liver Fibrosis: A Meta-AnalysisGastroenterology, 2008
- Hepatic venous pressure gradient as a predictor of fibrosis in chronic liver disease because of hepatitis B virusLiver International, 2008
- Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfectionJournal of Hepatology, 2006
- A model to predict survival in patients with end-stage liver diseaseJournal of Hepatology, 2001