{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:58:39Z","timestamp":1790477919385,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T00:00:00Z","timestamp":1515628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Two algorithms based on sequential measurements of liver and spleen stiffness using two\u2010dimensional shearwave elastography (2D\u2010<jats:styled-content style=\"fixed-case\">SWE<\/jats:styled-content>) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [<jats:styled-content style=\"fixed-case\">HVPG<\/jats:styled-content>] \u226510\u00a0mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To validate externally these algorithms in a large cohort of patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and ninety\u2010one patients with stable cirrhosis (Child\u2010Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D\u2010<jats:styled-content style=\"fixed-case\">SWE<\/jats:styled-content> at the time of <jats:styled-content style=\"fixed-case\">HVPG<\/jats:styled-content> measurement were included. Diagnostic accuracy of the 2 algorithms was assessed by calculating sensitivity, specificity, positive and negative predictive values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The first algorithm, using liver stiffness &lt;16.0\u00a0kilopascals (kPa) and then spleen stiffness &lt;26.6\u00a0kPa, was used to rule\u2010out <jats:styled-content style=\"fixed-case\">HVPG<\/jats:styled-content> \u226510\u00a0mm Hg. In our population, its sensitivity and negative predictive value were 95% and 63% respectively. The second algorithm, using liver stiffness &gt;38.0\u00a0kPa, or liver stiffness \u226438.0\u00a0kPa but spleen stiffness &gt;27.9\u00a0kPa, was used to rule\u2010in <jats:styled-content style=\"fixed-case\">HVPG<\/jats:styled-content> \u226510\u00a0mm Hg. In our population, its specificity and positive predictive value were 52% and 83% respectively. Restricting the analyses to the 74 patients without any history of decompensation of cirrhosis or to the 65 patients with highly reliable liver stiffness measurement did not improve the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our population, diagnostic accuracies of non\u2010invasive algorithms based on sequential measurements of liver and spleen stiffness using 2D\u2010<jats:styled-content style=\"fixed-case\">SWE<\/jats:styled-content> were acceptable, but not good enough to replace <jats:styled-content style=\"fixed-case\">HVPG<\/jats:styled-content> measurement or to base clinical decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14488","type":"journal-article","created":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T07:40:21Z","timestamp":1515656421000},"page":"621-630","source":"Crossref","is-referenced-by-count":55,"title":["Non\u2010invasive evaluation of portal hypertension using shear\u2010wave elastography: analysis of 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