Accurate ultrasonography-based portal pressure assessment in patients with hepatocellular carcinoma

Table 1 Characteristics of the included patients, n = 102

Index		Index
Age (yr)	54 ± 13	Globulin (g/dL)	30.5 ± 8.9
Gender (male/female)	65/37	Albumin (g/dL)	34.9 ± 5.9
Etiology, n	102	Total protein (g/dL)	65.5 ± 10.0
Virus	48	ALP (U/L)	120.6 ± 86.7
Alcohol	20	GGT (U/L)	67.7 ± 82.3
Cryptogenic	5	BUN (mmol/L)	6.8 ± 5.4
Multifactorial	20	Creatinine (μmol/L)	88.7 ± 138.6
Others	9	LDH (UL)	194.3 ± 59.8
GB history, n (%)	76 (74.51)	K (mmol/L)	4.0 ± 0.7
Refractory ascites, n (%)	78 (76.47)	Na (mmol/L)	138.4 ± 14.5
Encephalopathy, n (%)	4 (3.92)	Cl (mmol/L)	106.4 ± 5.1
Red blood cells (1012/L)	3.3 ± 1.6	Ca (mmol/L)	2.15 ± 0.15
Hemoglobin (g/L)	91.6 ± 25.3	Blood ammonia (μmol/L)	51.2 ± 30.0
White blood cells (1012/L)	4.1 ± 4.0	FIB (n/L)	2.3 ± 1.5
Platelet count (109/L)	106.7 ± 95.7	APTT (s)	34.5 ± 6.3
ALT (U/L)	24.4 ± 18.0	TT (s)	17.7 ± 5.4
AST (U/L)	35.0 ± 24.4	D dimer level (μg/L)	809 ± 1009
TBIL (mg/dL)	2.20 ± 3.61	Child–Pugh class, n (A/B/C)	26/58/18
DBIL (mg/dL)	1.41 ± 3.14	ALBI score	-2.06 ± 0.47
IBIL (mg/dL)	0.67 ± 0.43	MELD score	7.66 ± 5.46
PT(s)	14.6 ± 3.6	HVPG (mmHg)	17.07 ± 4.78
PT (%)	61.1 ± 16.6	PVP (mmHg)	34.40 ± 5.95
INR	1.4 ± 0.3	PPG (mmHg)	17.32 ± 1.97

GB: Gastrointestinal bleeding; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; PT: Prothrombin time; TBIL: Total bilirubin; INR: International normalized ratio; ALP: Alkaline phosphatase; GGT: Glutamyl transpeptidase; BUN: Blood urea nitrogen; LDH: Lactate dehydrogenase; APTT: Activated partial thromboplastin time; TT: Thrombin time; HVPG: Hepatic venous pressure gradient; PVP: Portal vein pressure; PPG: Portal pressure gradient.

Table 2 Results of ultrasonography examination

Parameter	Result
Portal vein diameter (cm)	1.20 ± 0.37
Portal vein velocity (cm/s)	25.1 ± 11.4
Portal blood flow (mL/min)	1729.9 ± 1003.1
Congestion index	0.11 ± 0.07
IVC diameter (cm)	8.7 ± 2.9
IVC blood velocity (cm/s)	62.2 ± 31.0
Spleen vein diameter (cm)	1.12 ± 0.23
Spleen vein velocity (cm/s)	11.51 ± 3.23

IVC: Inferior vena cava.

Table 3 Correlations between portal pressure gradient and clinicopathologic parameters and parameters of Doppler ultrasound

Index	Correlation with PPG (γ)	P value
Age (yr)	0.345	0.632
Peri-hepatic ascites (yes vs no)	0.753	0.233
Platelet count (× 109/L)	-0.341	0.061
Total bilirubin (mg/dL)	-0.231	0.487
Serum albumin (g/dL)	0.542	0.683
AST (IU/L)	0.452	0.712
ALT (IU/L)	0.028	0.652
NH3 (μg/dL)	0.126	0.515
MELD score	0.025	0.523
Portal vein diameter (cm)	0.102	0.019
Portal vein velocity (cm/s)	-0.321	0.034
Portal blood flow (mL/min)	-0.032	0.048
PV-CI	0.285	0.021
IVC diameter (cm)	0.129	0.496
IVC blood velocity (cm/s)	0.163	0.389
Spleen vein diameter (cm)	0.142	0.248
Spleen vein velocity (cm/s)	-0.062	0.654

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; MELD: Model for End-stage Liver Disease; PVV: Portal vein velocity; PV-CI: Portal vein congestion index.

Table 4 Multiple linear regression stepwise method output using ultrasonography Doppler data for correlations with portal pressure gradient

Model	Unstandardized coefficients			Standardized coefficient	T value	P value	95% Confidence Interval
	β		Standard error	β
1 (Constant)	19.432	2.785			8.538	0.000	15.133-21.482
SV (cm3)	-0.212	0.214		-0.265	-1.432	0.654	-0.378-0.431
PVD (cm)	0.322	0.254		0.331	0.085	0.723	0.134-0.564
PVV (cm/s)	-0.323	0.187		-0.353	-1.572	0.157	-0.623-0.113
PBF (mL/min)	0.001	0.056		0.274	1.431	0.197	0.023-0.422
2 (Constant)	19.345	2.634			8.634	0.000	15.268-21.372
PVD (cm)	0.312	0.262		0.232	0.079	0.654	0.211-0.592
PVV (cm/s)	-0.343	0.232		-0.412	-1.548	0.132	-0.451-0.065
PBF (mL/min)	0.001	0.067		0.283
3 (Constant)	19.336	2.543			8.634	0.000	16.235-22.354
PVV (cm/s)	-0.312	0.134		-0.532	-2.645	0.032	-0.454-0.001
PBF (mL/min)	0.001	0.078		0.276	2,143	0.025	0.034-0.462

SV: Spleen volume; PVD: Portal vein diameter; PVV: Portal vein velocity; PBF: Portal vein flow.