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Related Concept Videos

Portal Hypertension01:22

Portal Hypertension

Portal hypertension is an increase in blood pressure within the portal venous system. Normally, this pressure is less than 5 mmHg. It is considered clinically significant when it rises above 10 mmHg. At this threshold, complications from altered blood flow and venous congestion emerge.EtiologyPortal hypertension arises from conditions that impede blood flow through the liver. The most common cause is cirrhosis, in which chronic liver injury leads to fibrotic scarring. This fibrosis narrows or...
Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

Ultrasound II: Endoscopic Ultrasound and FibroScan

Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):

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Related Experiment Video

Updated: Jun 7, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Published on: June 18, 2020

Endoscopic Ultrasound-Guided Versus Transjugular Portal Pressure Measurements: Systematic Review and Meta-Analysis.

Rintaro Hashimoto1, Tomohiro Tanaka2, Kenneth J Chang3

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa Health Care, 200 Hawkins Dr, Iowa City, IA, 52242, USA. rintaro-hashimoto@uiowa.edu.

Digestive Diseases and Sciences
|June 5, 2026
PubMed
Summary

Endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurements show strong correlation with invasive methods. However, more research is needed to confirm agreement and clinical applicability for portal hypertension management.

Keywords:
EndosonographyMeta-analysis as topicPortal hypertensionPortal pressureSystematic reviews as topic

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Contrast-Enhanced Subharmonic Aided Pressure Estimation (SHAPE) Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension
06:20

Contrast-Enhanced Subharmonic Aided Pressure Estimation (SHAPE) Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

Published on: December 5, 2020

Related Experiment Videos

Last Updated: Jun 7, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Published on: June 18, 2020

Contrast-Enhanced Subharmonic Aided Pressure Estimation (SHAPE) Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension
06:20

Contrast-Enhanced Subharmonic Aided Pressure Estimation (SHAPE) Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

Published on: December 5, 2020

Area of Science:

  • Gastroenterology
  • Medical Imaging
  • Interventional Endoscopy

Background:

  • Published reviews highlight the feasibility and safety of endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurements.
  • Existing literature primarily focuses on the technical aspects rather than the direct comparability with invasive hemodynamic assessments.

Purpose of the Study:

  • To systematically review and meta-analyze prospective paired studies evaluating the correlation between EUS-based portal pressure measurements and invasive comparator methods.
  • To assess the agreement, technical success rates, and adverse events associated with EUS-PPG measurements.

Main Methods:

  • A systematic search of major databases was conducted up to January 2026 for prospective cohorts.
  • Studies included same-patient EUS-based portal pressure measurements and invasive hemodynamic measurements (hepatic venous pressure gradient [HVPG] or direct portal venous pressure).
  • Correlations were pooled using random-effects models, and agreement was descriptively summarized.

Main Results:

  • Six prospective cohorts comprising 127 attempted procedures were analyzed.
  • Pooled correlations were strong: 0.82 (95% CI, 0.72-0.89) with HVPG and 0.86 (95% CI, 0.72-0.93) with direct portal venous pressure.
  • Technical success was high (95.3%), with a low adverse event rate (2.4%) and no procedure-related deaths. However, agreement limits were wide (-6 to +7 mmHg).

Conclusions:

  • EUS-based portal pressure measurement demonstrates feasibility and a strong association with invasive hemodynamic comparators.
  • The current evidence base is limited, necessitating further investigation into patient-level agreement and procedural reproducibility.
  • Future research should focus on establishing EUS-specific thresholds for clinically significant portal hypertension and the transferability of HVPG-based decision thresholds.