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| Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis |
| Stefania Gioia a , ∗, Adriano De Santis a , Giulia d’Amati b , Silvia Nardelli a , Alessandra Spagnoli c , Arianna Di Rocco c , Lorenzo Ridola a , Oliviero Riggio a |
a Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
b Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy
c Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
∗Corresponding author.
E-mail address: stensgioia@hotmail.com (S. Gioia) . |
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Abstract Background: Porto-sinusoidal vascular disease (PSVD) and portal vein thrombosis (PVT) are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal system. As PVT may be a consequence of PSVD, in PVT patients at presentation, a pre-existing PSVD should be suspected. In these patients the identification of an underlying PSVD would have rele- vant implication regarding follow-up and therapeutic management, but it could be challenging. In this setting ultrasonography may be valuable in differential diagnosis. The aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and “pure”PVT and then to suspect PVT secondary to a pre-existing PSVD.
Methods: Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse (ARFI).
Results: ARFI was higher and superior mesenteric vein (SMV) diameter was wider in PSVD patients than in PVT patients. Thus, a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT (the area under the curve = 0.780; 95% confidence interval: 0.690-0.869).
Conclusions: A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.
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2024, Vol. 23 
