Fabrizio Termite, Federica Borrelli de Andreis, Antonio Liguori, Antonio Gasbarrini, Fabia Attili, Cristiano Spada, Luca Miele
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引用次数: 0
Abstract
Background: Portal hypertension (PH) is a critical complication in patients with hepatic diseases. Its accurate evaluation is essential for early diagnosis, risk stratification, and management. Endoscopic ultrasound (EUS) has emerged as a promising diagnostic tool, offering high-resolution imaging of the portal venous system, hepatic vasculature, and surrounding structures.
Aims: This review aims at providing an overview of the evolving role of EUS in PH evaluation in patients with liver disease.
Materials and methods: A systematic search was conducted in PubMed and Google Scholar until 31 May 2024. Relevant studies were identified using keywords related to EUS and PH. Additional references were included based on expert knowledge and citation analysis. Only full-length papers and abstracts in English were considered.
Results: EUS demonstrates significant utility in PH assessment, offering high-resolution imaging and advanced tools like contrast enhancement (CE) and shear-wave elastography (SWE) for evaluating liver stiffness and correlating it with PH severity. EUS-guided portal pressure gradient (PPG) measurement provides a less invasive method for evaluating PH, potentially offering a safer alternative to conventional techniques.
Discussion: EUS offers unique advantages in PH assessment, enabling comprehensive evaluation in a single session. Despite its potential, limitations such as invasiveness, sedation-related variability, and restricted availability persist. Emerging techniques require further validation in larger cohorts and standardised training.
Conclusion: EUS is a valuable diagnostic tool for PH evaluation, with the potential to improve outcomes through earlier diagnosis and better stratification. Addressing its limitations through further research and standardised protocols is critical to optimize its clinical utility.
Trial registration: NCT04115046, NCT05728697, NCT05097963 and NCT03155282.
期刊介绍：
Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.
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