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2017 ; 5
(2
): 79-89
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gab.com Text
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Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of
fibrosis and liver biopsy
#MMPMID28533906
Procopet B
; Berzigotti A
Gastroenterol Rep (Oxf)
2017[May]; 5
(2
): 79-89
PMID28533906
show ga
The concept of 'cirrhosis' is evolving and it is now clear that compensated and
decompensated cirrhosis are completely different in terms of prognosis.
Furthermore, the term 'advanced chronic liver disease (ACLD)' better reflects the
continuum of histological changes occurring in the liver, which continue to
progress even after cirrhosis has developed, and might regress after removing the
etiological factor causing the liver disease. In compensated ACLD, portal
hypertension marks the progression to a stage with higher risk of clinical
complication and requires an appropriate evaluation and treatment. Invasive tests
to diagnose cirrhosis (liver biopsy) and portal hypertension (hepatic venous
pressure gradient measurement and endoscopy) remain of crucial importance in
several difficult clinical scenarios, but their need can be reduced by using
different non-invasive tests in standard cases. Among non-invasive tests, the
accepted use, major limitations and major benefits of serum markers of fibrosis,
elastography and imaging methods are summarized in the present review.