To describe the cause, mechanism, clinical manifestations, and complications of portal hypertension (PH) To introduce non-invasive ultrasonography based tools, includingthe latest toolsfor assessment and prediction of PH To outline the radiologic findings and clinical implications of varices in PH To discuss the interventional managementfor PH and its complications

Portal hypertension (PH) is a common consequence of chronic liver diseases and leads to major complications of liver cirrhosis, such as ascites, hepatic encephalopathy, and variceal bleeding. Definition of Portal Hypertension PH is an increase of the hydrostatic pressure within the portal vein or its tributaries, which is manifested as anincrease in the pressure gradient between the portal vein and hepatic vein or the inferior vena cava (IVC). Hepatic venous pressure gradient (HVPG) is calculated by subtracting the free hepatic venous pressure from the wedged...

I. Various Tools for Assessment and Prediction of PH 1. Gold standard methods Measurement of hepatic venous pressure gradient (HVPG) and upperGI endoscopy are considered the gold standards for PH assessment in patients with cirrhosis. Hepatic venous pressure gradient (HVPG) HVPG is calculated by subtracting the free hepatic venous pressure (FHVP)from the wedged hepatic venous pressure (WHVP) and these values areobtained by hepatic vein catheterization[2]. FHVP is determined bydirect measurement of hepatic venous pressure WHVP is typically obtained by balloon occlusion of the hepatic vein,...

Radiologists play an important role in diagnosis and treatment of PH and its complications. Thus, we should know various radioliogic tools for assessing andmanaging PH. Knowledge of the US-based tools and CT findings of varices at each anatomic location allows accurate diagnosis before the serious consequences for varices.

ADDIN EN.REFLIST 1. Arora A, Rajesh S, Meenakshi YS, Sureka B, Bansal K, Sarin SK. Spectrum of hepatofugal collateral pathways in portal hypertension: an illustrated radiological review. Insights Imaging. 2015;6(5):559-72. 2. Kumar A, Sharma P, Sarin SK. Hepatic venous pressure gradient measurement: time to learn! Indian J Gastroenterol. 2008;27(2):74-80. 3.Castera L, Pinzani M, Bosch J. Non invasive evaluation of portal hypertension using transient elastography. J Hepatol. 2012;56(3):696-703. 4.Maruyama H, Yokosuka O. Ultrasonography for Noninvasive Assessment of Portal Hypertension. Gut Liver. 2017;11(4):464-73. 5. Weinreb J, Kumari...