CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg

Abstract To investigate the diagnostic utility of a noninvasive method based on spleen volume for the accurate diagnosis of severe portal hypertension (PH). We enrolled 260 patients undergoing hepatic venous pressure gradient (HVPG) assessment and enhanced CT at Tianjin Third Central Hospital (Decem...

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Main Authors: Xinyu Chen, Jiamei Zhou, Yicheng Lin, Kefeng Jia, Jiajun Tian, Fenghui Li, Rong Lv, Weili Yin, Fang Wang, Ping Zhu, Chao Yang, Jiayin Wang, Tao Wang, Junqing Yan, Ying Liu, Qing Ye, Huiling Xiang
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Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-02143-3
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author Xinyu Chen
Jiamei Zhou
Yicheng Lin
Kefeng Jia
Jiajun Tian
Fenghui Li
Rong Lv
Weili Yin
Fang Wang
Ping Zhu
Chao Yang
Jiayin Wang
Tao Wang
Junqing Yan
Ying Liu
Qing Ye
Huiling Xiang
author_facet Xinyu Chen
Jiamei Zhou
Yicheng Lin
Kefeng Jia
Jiajun Tian
Fenghui Li
Rong Lv
Weili Yin
Fang Wang
Ping Zhu
Chao Yang
Jiayin Wang
Tao Wang
Junqing Yan
Ying Liu
Qing Ye
Huiling Xiang
author_sort Xinyu Chen
collection DOAJ
description Abstract To investigate the diagnostic utility of a noninvasive method based on spleen volume for the accurate diagnosis of severe portal hypertension (PH). We enrolled 260 patients undergoing hepatic venous pressure gradient (HVPG) assessment and enhanced CT at Tianjin Third Central Hospital (December 2019–July 2023), with clinical data collected. Patients were stratified by HVPG levels: ≥16 mmHg (severe PH group) and < 16 mmHg (non-severe PH group). We included 120 cirrhotic patients who met the inclusion criteria. Splenic volume exhibited a linear correlation with HVPG (r = 0.364, p < 0.001). Univariate and multivariate logistic regression analyses identified spleen volume, age, and serum albumin as independent risk factors for severe PH (p < 0.05). Accordingly, a clinical diagnostic model was developed, named the “S-HVPG” score. The area under the curve (AUC) for the “S-HVPG” score was 0.803, with an optimal threshold of 0.694, achieving sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of 78.8%, 74.3%, 88.2%, and 59.1%, respectively. The spleen volume-based “S-HVPG” scoring system introduces a novel, straightforward, noninvasive approach for diagnosing severe PH. A cutoff value of 0.694 for the S-HVPG score effectively distinguishes patients with severe PH from those with cirrhosis.
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spelling doaj-art-0dabe8feba5e46dd906b486004e58d5e2025-08-20T04:02:45ZengNature PortfolioScientific Reports2045-23222025-05-011511910.1038/s41598-025-02143-3CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhgXinyu Chen0Jiamei Zhou1Yicheng Lin2Kefeng Jia3Jiajun Tian4Fenghui Li5Rong Lv6Weili Yin7Fang Wang8Ping Zhu9Chao Yang10Jiayin Wang11Tao Wang12Junqing Yan13Ying Liu14Qing Ye15Huiling Xiang16The Third Central Clinical College of Tianjin Medical University, Tianjin University Central Hospital (Tianjin Third Central Hospital), Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin Union Medical Center, Tianjin Medical UniversityThe Third Central Clinical College of Tianjin Medical University, Tianjin University Central Hospital (Tianjin Third Central Hospital), Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjin University Central Hospital(Tianjin Third Central Hospital), Department of Gastroenterology and Hepatology, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseAbstract To investigate the diagnostic utility of a noninvasive method based on spleen volume for the accurate diagnosis of severe portal hypertension (PH). We enrolled 260 patients undergoing hepatic venous pressure gradient (HVPG) assessment and enhanced CT at Tianjin Third Central Hospital (December 2019–July 2023), with clinical data collected. Patients were stratified by HVPG levels: ≥16 mmHg (severe PH group) and < 16 mmHg (non-severe PH group). We included 120 cirrhotic patients who met the inclusion criteria. Splenic volume exhibited a linear correlation with HVPG (r = 0.364, p < 0.001). Univariate and multivariate logistic regression analyses identified spleen volume, age, and serum albumin as independent risk factors for severe PH (p < 0.05). Accordingly, a clinical diagnostic model was developed, named the “S-HVPG” score. The area under the curve (AUC) for the “S-HVPG” score was 0.803, with an optimal threshold of 0.694, achieving sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of 78.8%, 74.3%, 88.2%, and 59.1%, respectively. The spleen volume-based “S-HVPG” scoring system introduces a novel, straightforward, noninvasive approach for diagnosing severe PH. A cutoff value of 0.694 for the S-HVPG score effectively distinguishes patients with severe PH from those with cirrhosis.https://doi.org/10.1038/s41598-025-02143-3CirrhosisPortal hypertensionSpleen volumeHepatic venous pressure gradientDiagnostic model
spellingShingle Xinyu Chen
Jiamei Zhou
Yicheng Lin
Kefeng Jia
Jiajun Tian
Fenghui Li
Rong Lv
Weili Yin
Fang Wang
Ping Zhu
Chao Yang
Jiayin Wang
Tao Wang
Junqing Yan
Ying Liu
Qing Ye
Huiling Xiang
CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
Scientific Reports
Cirrhosis
Portal hypertension
Spleen volume
Hepatic venous pressure gradient
Diagnostic model
title CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
title_full CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
title_fullStr CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
title_full_unstemmed CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
title_short CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg
title_sort ct derived spleen volume accurately diagnoses severe portal hypertension at hvpg thresholds of 16 mmhg
topic Cirrhosis
Portal hypertension
Spleen volume
Hepatic venous pressure gradient
Diagnostic model
url https://doi.org/10.1038/s41598-025-02143-3
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