Clinical Study
Liver and Spleen Stiffness Measurements for Assessment of Portal Hypertension Severity in Patients with Budd Chiari Syndrome
Table 1
Main demographic, clinical, and radiological findings in our patient cohort with BCS.
| | Patient | Sex, Age | Etiological/Risk Factors | Prognostic Index (PI) at diagnosis | Outflow Obstruction; | Treatment | Time point of TE | LSM (kPa) | SSM (kPa) | Events after TE evaluation | | MELD-Na | Child-Pugh | Rotterdam Score# | Clichy |
| | 1. | F, 34 | ET, JAK2- | 10 | 7 | 1.11 | 4.7 | 2/3 HVs fibrotic, thrombosis of portal, mesenteric and splenic vein | VKA | At diagnosis | 75 | 75 | Refractory ascites, TIPS | | TIPS | 1 year after TIPS | 8 | 65 | No CD |
| | 2. | F, 65 | ET, JAK2+ | 13 | 6 | 1.15 | 5.2 | Complete thrombosis of all HVs | VKA | At diagnosis | 75 | 75 | Recurrent CD events TIPS, OLT | | TIPS | Before TIPS placement | 75 | 75 | | OLT |
| | 3. | M, 25 | None | 13 | 5 | 0.11 | 3.3 | 2/3 HVs interrupted, 1 partially thrombosed | NSBB | At diagnosis | 75 | 75 | Several CD events, OLT |
| | 4. | M, 52 | PV, JAK2- | 12 | 5 | 0.10 | 4.9 | IVC thrombosis | NSBB VKA | Before TIPS placement | 75 | 75 | Single episode of HE after TIPS | | TIPS | 10 years after TIPS | 7.3 | 75 |
| | 5. | F, 65 | PV, JAK2+ | 10 | 6 | 1.17 | 4.8 | TIPS occluded | VKA | TIPS occlusion | 75 | 75 | Patency of paraumbilical vein, EV development | | TIPS |
| | 6. | F, 61 | None | 7 | 5 | 0.02 | 3.2 | 1/3 HVs obstructed | VKA | At diagnosis | 34.8 | 38.5 | No CD | | 1 year after diagnosis | 26.6 | 35.2 |
| | 7. | F, 23 | Behçet’s disease | 8 | 5 | 0.03 | 3.1 | 2/3 HVs partially obstructed | VKA | At diagnosis | 14.3 | 47.2 | No CD | | 3 years after diagnosis | 11.8 | 40 |
|
|
#Rotterdam Score: 1.27 x encephalopathy + 1.04 x ascites + 0.72 x prothrombin time + 0.004 bilirubin ( µmol/L). Clichy Score: ascites score × 0.75 + Pugh score × 0.28 + age × 0.037 + creatinine × 0.0036 ( µmol/L). CD: clinical decompensation; ET: Essential Thrombocythemia; EV: esophageal varices; F: female; HV: hepatic vein; LSM: liver stiffness measurement; M: male; NSBB: nonselective beta-blocker; OLT: orthotopic liver transplantation; PV: Polycythemia Vera; SSM: Spleen Stiffness Measurement; TE: Transient Elastography; TIPS: transjugular intrahepatic portosystemic shunt; VKA: vitamin K antagonists. |
