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 relevant 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.
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.
摘要：
背景：门窦血管疾病（PSVD）和门静脉血栓形成（PVT）是门脉高压的原因，其特征分别是肝内和肝前对门脉系统血流的障碍。由于PVT可能是PSVD的结果，在PVT患者中，应该怀疑预先存在的PSVD。在这些患者中，潜在PSVD的识别将对随访和治疗管理具有相关意义。但这很有挑战性.在这种情况下，超声检查在鉴别诊断中可能很有价值。该研究的目的是使用超声检查来识别参数以区分PSVD和“纯”PVT，然后怀疑先前存在的PSVD继发的PVT。
方法：纳入53例经组织学证实的PSVD患者和48例受慢性PVT影响的患者，并通过声辐射力脉冲（ARFI）进行腹部超声弹性成像。
结果：与PVT患者相比，PSVD患者的ARFI更高，肠系膜上静脉（SMV）直径更宽。因此，预后评分是两个参数的线性组合,在PSVD和PVT之间具有良好的辨别能力(曲线下面积=0.780;95%置信区间:0.690~0.869).
结论：基于ARFI和SMV直径的评分可能有助于怀疑PVT患者的潜在PSVD，并确定接受肝活检的患者亚组。
方法：纳入53例经组织学证实的PSVD患者和48例受慢性PVT影响的患者，并通过声辐射力脉冲（ARFI）进行腹部超声弹性成像。
结果：与PVT患者相比，PSVD患者的ARFI更高，肠系膜上静脉（SMV）直径更宽。因此，预后评分是两个参数的线性组合,在PSVD和PVT之间具有良好的辨别能力(曲线下面积=0.780;95%置信区间:0.690~0.869).
结论：基于ARFI和SMV直径的评分可能有助于怀疑PVT患者的潜在PSVD，并确定接受肝活检的患者亚组。
