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Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study

BACKGROUND AND AIMS: Porto‐sinusoidal vascular disorder (PSVD) is a rare and commonly overlooked cause of portal hypertension. The interest of CT analysis, including quantification of liver surface nodularity (LSN) for PSVD diagnosis has not been established. This study aimed at assessing the perfor...

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Autores principales: Valainathan, Shantha Ram, Sartoris, Riccardo, Elkrief, Laure, Magaz, Marta, Betancourt, Fabian, Pellegrino, Silvia, Nivolli, Arianna, Dioguardi Burgio, Marco, Flattet, Yves, Terraz, Sylvain, Drilhon, Nicolas, Lazareth, Marie, Herrou, Julia, Bruno, Onorina, Payance, Audrey, Plessier, Aurélie, Durand, François, Ronot, Maxime, Valla, Dominique‐Charles, Paradis, Valérie, Garcia‐Pagan, Juan Carlos, Vilgrain, Valérie, Rautou, Pierre‐Emmanuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544289/
https://www.ncbi.nlm.nih.gov/pubmed/35092315
http://dx.doi.org/10.1002/hep.32367
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author Valainathan, Shantha Ram
Sartoris, Riccardo
Elkrief, Laure
Magaz, Marta
Betancourt, Fabian
Pellegrino, Silvia
Nivolli, Arianna
Dioguardi Burgio, Marco
Flattet, Yves
Terraz, Sylvain
Drilhon, Nicolas
Lazareth, Marie
Herrou, Julia
Bruno, Onorina
Payance, Audrey
Plessier, Aurélie
Durand, François
Ronot, Maxime
Valla, Dominique‐Charles
Paradis, Valérie
Garcia‐Pagan, Juan Carlos
Vilgrain, Valérie
Rautou, Pierre‐Emmanuel
author_facet Valainathan, Shantha Ram
Sartoris, Riccardo
Elkrief, Laure
Magaz, Marta
Betancourt, Fabian
Pellegrino, Silvia
Nivolli, Arianna
Dioguardi Burgio, Marco
Flattet, Yves
Terraz, Sylvain
Drilhon, Nicolas
Lazareth, Marie
Herrou, Julia
Bruno, Onorina
Payance, Audrey
Plessier, Aurélie
Durand, François
Ronot, Maxime
Valla, Dominique‐Charles
Paradis, Valérie
Garcia‐Pagan, Juan Carlos
Vilgrain, Valérie
Rautou, Pierre‐Emmanuel
author_sort Valainathan, Shantha Ram
collection PubMed
description BACKGROUND AND AIMS: Porto‐sinusoidal vascular disorder (PSVD) is a rare and commonly overlooked cause of portal hypertension. The interest of CT analysis, including quantification of liver surface nodularity (LSN) for PSVD diagnosis has not been established. This study aimed at assessing the performance of LSN and CT features for a PSVD diagnosis in patients with signs of portal hypertension. APPROACH AND RESULTS: This retrospective case‐control study included a learning cohort consisting of 50 patients with histologically proven PSVD, according to VALDIG criteria, and 100 control patients with histologically proven cirrhosis, matched on ascites. All patients and controls had at least one sign of portal hypertension and CT available within 1 year of liver biopsy. Principal component analysis of CT features separated patients with PSVD from patients with cirrhosis. Patients with PSVD had lower median LSN than those with cirrhosis (2.4 vs. 3.1, p < 0.001). Multivariate analysis identified LSN < 2.5 and normal‐sized or enlarged segment IV as independently associated with PSVD. Combination of these two features had a specificity of 90% for PSVD and a diagnostic accuracy of 84%. Even better results were obtained in an independent multicenter validation cohort including 53 patients with PSVD and 106 control patients with cirrhosis (specificity 94%, diagnostic accuracy 87%). CONCLUSIONS: This study that included a total of 103 patients with PSVD and 206 patients with cirrhosis demonstrates that LSN < 2.5 combined with normal‐sized or enlarged segment IV strongly suggests PSVD in patients with signs of portal hypertension.
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spelling pubmed-95442892022-10-14 Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study Valainathan, Shantha Ram Sartoris, Riccardo Elkrief, Laure Magaz, Marta Betancourt, Fabian Pellegrino, Silvia Nivolli, Arianna Dioguardi Burgio, Marco Flattet, Yves Terraz, Sylvain Drilhon, Nicolas Lazareth, Marie Herrou, Julia Bruno, Onorina Payance, Audrey Plessier, Aurélie Durand, François Ronot, Maxime Valla, Dominique‐Charles Paradis, Valérie Garcia‐Pagan, Juan Carlos Vilgrain, Valérie Rautou, Pierre‐Emmanuel Hepatology Original Articles BACKGROUND AND AIMS: Porto‐sinusoidal vascular disorder (PSVD) is a rare and commonly overlooked cause of portal hypertension. The interest of CT analysis, including quantification of liver surface nodularity (LSN) for PSVD diagnosis has not been established. This study aimed at assessing the performance of LSN and CT features for a PSVD diagnosis in patients with signs of portal hypertension. APPROACH AND RESULTS: This retrospective case‐control study included a learning cohort consisting of 50 patients with histologically proven PSVD, according to VALDIG criteria, and 100 control patients with histologically proven cirrhosis, matched on ascites. All patients and controls had at least one sign of portal hypertension and CT available within 1 year of liver biopsy. Principal component analysis of CT features separated patients with PSVD from patients with cirrhosis. Patients with PSVD had lower median LSN than those with cirrhosis (2.4 vs. 3.1, p < 0.001). Multivariate analysis identified LSN < 2.5 and normal‐sized or enlarged segment IV as independently associated with PSVD. Combination of these two features had a specificity of 90% for PSVD and a diagnostic accuracy of 84%. Even better results were obtained in an independent multicenter validation cohort including 53 patients with PSVD and 106 control patients with cirrhosis (specificity 94%, diagnostic accuracy 87%). CONCLUSIONS: This study that included a total of 103 patients with PSVD and 206 patients with cirrhosis demonstrates that LSN < 2.5 combined with normal‐sized or enlarged segment IV strongly suggests PSVD in patients with signs of portal hypertension. John Wiley and Sons Inc. 2022-02-16 2022-08 /pmc/articles/PMC9544289/ /pubmed/35092315 http://dx.doi.org/10.1002/hep.32367 Text en © 2022 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Valainathan, Shantha Ram
Sartoris, Riccardo
Elkrief, Laure
Magaz, Marta
Betancourt, Fabian
Pellegrino, Silvia
Nivolli, Arianna
Dioguardi Burgio, Marco
Flattet, Yves
Terraz, Sylvain
Drilhon, Nicolas
Lazareth, Marie
Herrou, Julia
Bruno, Onorina
Payance, Audrey
Plessier, Aurélie
Durand, François
Ronot, Maxime
Valla, Dominique‐Charles
Paradis, Valérie
Garcia‐Pagan, Juan Carlos
Vilgrain, Valérie
Rautou, Pierre‐Emmanuel
Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title_full Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title_fullStr Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title_full_unstemmed Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title_short Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study
title_sort contrast‐enhanced ct and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: a case‐control study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544289/
https://www.ncbi.nlm.nih.gov/pubmed/35092315
http://dx.doi.org/10.1002/hep.32367
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