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    Noncontrast-enhanced MRI-based noninvasive score for portal hypertension (CHESS1802): An international multicenter study
    (Xia & He Publishing Inc., 2021) Liu, Yanna; Tang, Tianyu; Örmeci, Necati; Huang, Yifei; Wang, Jitao; Li, Xiaoguo; Li, Zhiwei; An, Weimin; Liu, Dengxiang; Zhang, Chunqing; Liu, Changchun; Liu, Jinqiang; Liu, Chuan; Wang, Guangchuan; Mosconi, Cristina; Cappelli, Alberta; Bruno, Antonio; Akçalar, Seray; Çelebioğlu, Emrecan; Üstüner, Evren; Bilgiç, Sadık; Ellik, Zeynep; Asiller, Özgün Ömer
    Background and Aims This study aimed to determine the performance of the non-invasive score using noncontrast-enhanced MRI (CHESS-DIS score) for detecting portal hypertension in cirrhosis. Methods In this international multicenter, diagnostic study (ClinicalTrials.gov, NCT03766880), patients with cirrhosis who had hepatic venous pressure gradient (HVPG) measurement and noncontrast-enhanced MRI were prospectively recruited from four university hospitals in China (n=4) and Turkey (n=1) between December 2018 and April 2019. A cohort of patients was retrospectively recruited from a university hospital in Italy between March 2015 and November 2017. After segmentation of the liver on fat-suppressed T1-weighted MRI maps, CHESS-DIS score was calculated automatically by an in-house developed code based on the quantification of liver surface nodularity. Results A total of 149 patients were included, of which 124 were from four Chinese hospitals (training cohort) and 25 were from two international hospitals (validation cohort). A positive correlation between CHESS-DIS score and HVPG was found with the correlation coefficients of 0.36 (p<0.0001) and 0.55 (p<0.01) for the training and validation cohorts, respectively. The area under the receiver operating characteristic curve of CHESS-DIS score in detection of clinically significant portal hypertension (CSPH) was 0.81 and 0.9 in the training and validation cohorts, respectively. The intraclass correlation coefficients for assessing the inter- and intra-observer agreement were 0.846 and 0.841, respectively. Conclusions A non-invasive score using noncontrast-enhanced MRI was developed and proved to be significantly correlated with invasive HVPG. Besides, this score could be used to detect CSPH in patients with cirrhosis.
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    Tolerance and acceptance of hepatic venous pressure gradient measurement in cirrhosis (CHESS1904): An international multicenter study
    (Wiley, 2022) Sun, Jun‐Hui; Zhao, He; Zhang, Haijun; Lei, Li; Örmeci, Necati; Yu, Zi‐Niu; Li, Xun; Li, Shuangxi; Yang, Xujun; Wei, Huaping; Zhu, Xiaoliang; Zhang, Zhengcong; Wang, Yajin; Zhao, Zhongwei; Mao, Jianting; Wu, Qiaohong; Sun, Xiaole; Xiang, Huiling; Jia, Kefeng; Yang, Chao; Wu, Wei; Lin, Xiuqing; Yao, Haixin; Zuo, Changzeng; Wang, Jitao; Zhang, Bo; Zhang, Chunqing; Wu, Xiaoling; Wang, Guangchuan; Yao, Shengjuan; Wang, Ruihang; Zhou, Li; Huan, Hui; Tu, Qingli; Pu, Xue; Zhang, Feng; Yin, Qin; Zhang, Linpeng; Guo, Ying; Wang, Jian; Kotani, Kohei; Uchida‐Kobayashi, Sawako; Kawada, Norifumi; Zhu, He; Li, Li; Wang, Wei; Zhang, Guo; Yu, Lei; Cui, Xudong; Zhu, Qingliang; Zhang, Hailong; Hui, Xiaoli; O. Ximenes, Rafael; de Araújo, Adriano Gonçalves; Gardenghi, Giulliano; Zheng, Yubao; Wu, Zebin; Huang, Mingsheng; Chen, Xiaoyong; Wu, Jun; Xie, Feng; Bo, Yang; Hu, Shengjuan; Ma, Linke; Li, Xiao; Qi, Xiaolong
    Aim To determine the tolerance and acceptance of hepatic venous pressure gradient (HVPG) measurements in patients with liver cirrhosis. Methods This prospective international multicenter study included 271 patients with cirrhosis who were scheduled to undergo HVPG measurement between October 2019 and June 2020. Data related to the tolerance and acceptance of HVPG measurements were collected using descriptive questionnaires. Results HVPG measurements were technically successful in all 271 patients, with 141 (52.0%) undergoing HVPG measurement alone. The complication rate was 0.4%. Postoperative pain was significantly lower than preoperative expected pain (p < 0.001) and intraoperative pain (p < 0.001), and intraoperative pain was also significantly lower than preoperative expected pain (p = 0.036). No, mild, moderate, severe, and intolerable discomfort scores were reported by 36.9%, 44.6%, 11.1%, 6.3%, and 0.4% of these patients, respectively, during HVPG measurement and by 54.6% 32.5%, 11.4%, 1.5%, and 0%, respectively, after HVPG measurement. Of these patients, 39.5% had little understanding and 10% had no understanding of the value of HVPG measurement, with 35.1% and 4.1% regarding HVPG measurements as being of little or no help, respectively. Most patients reported that they would definitely (15.5%), probably (46.9%), or possibly (29.9%) choose to undergo additional HVPG measurements again, and 62.7% regarded the cost of the procedure as acceptable. Conclusion HVPG measurement was safe and well-tolerated in patients with cirrhosis, but patient education and communication are warranted to improve the acceptance of this procedure.