Suspended

Diagnostic Role of the Hepatic Venous Pressure Gradient and Elastography in Porto-sinusoidal Vascular Disorder With Portal Hypertension

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What is being tested

Hepatic vein pressure gradient measurement

+ Ultrasound-guided percutaneous liver biopsy

+ Multiparametric Abdominal Magnetic Resonance with Elastography

ProcedureDiagnostic Test
Who is being recruted

Idiopathic Noncirrhotic Portal Hypertension+1

+ Digestive System Diseases

+ Hypertension, Portal

From 18 to 80 Years
See all eligibility criteria
How is the trial designed

Diagnostic Study

Interventional
Study Start: March 2023
See protocol details

Summary

Principal SponsorUniversidade Federal do Rio de Janeiro
Study ContactGuilherme FM Rezende, MD, PhDMore contacts
Last updated: January 28, 2026
Sourced from a government-validated database.Claim as a partner

Study start date: March 1, 2023

Actual date on which the first participant was enrolled.

Porto-sinusoidal vascular disorder (PSVD) is considered a rare cause of portal hypertension (PH), resulting from specific histological alterations that essentially affect the small portal branches and sinusoids, in the absence of cirrhosis. In recent years, the recognition and importance of PSVD has increased, notably due to the widespread use of transient elastography (TE). However, the definitive diagnosis of PSVD can only be established through liver biopsy. Recent data show that PSVD should be suspected in patients with PH and TE ≤ 20 kPa and liver biopsy should be considered in this context. The investigators hypothesize that hepatic venous pressure gradient (HVPG) and magnetic resonance liver elastography (MRE) may help in the selection of liver biopsy candidates for the diagnosis of PSVD. Primary objectives are: * To describe the measurement of the hepatic venous pressure gradient (in mmHg) in patients with portal hypertension and transient hepatic elastography ≤ 20 kPa. * To describe hepatic (in kPa) and splenic (in kPa) stiffness measured by magnetic resonance elastography in patients with portal hypertension and transient hepatic elastography ≤ 20 kPa. * To describe the frequency of major histological findings for the diagnosis of portal sinusoidal vascular disorder (obliterative portal venopathy, regenerative nodular hyperplasia and incomplete septal cirrhosis) in patients with portal hypertension and transient hepatic elastography ≤ 20 kPa. Secondary objectives are: * To describe the frequency of hepatic vein-to-vein communications in patients with portal hypertension and transient hepatic elastography ≤ 20 kPa. * To describe the frequency of minor histological findings for the diagnosis of portal sinusoidal vascular disease (portal tract abnormalities, architectural disturbances, nonzonal sinusoidal dilatation, mild perisinusoidal fibrosis) in patients with portal hypertension and transient hepatic elastography ≤ 20 kPa. * To compare the serum values of von Willebrand antigen factor (IU/mL) between patients diagnosed with porto-sinusoidal vascular disorder and those diagnosed with cirrhosis, after analysis of liver biopsy. * To compare the serum titers of procollagen III amino-terminal peptide (mcg/l) between patients diagnosed with portosinusoidal vascular disorder and those diagnosed with cirrhosis, after analysis of liver biopsy. * To compare the serum titers of anti-endothelial cell antibodies between patients diagnosed with portosinusoidal vascular disorder and those diagnosed with cirrhosis, after analysis of liver biopsy. 50 patients will be included, prospectively and retrospectively, in a comparative study between diagnostic methods, with a cross-sectional design.

Official TitleDiagnostic Role of the Hepatic Venous Pressure Gradient and Elastography in Porto-sinusoidal Vascular Disorder With Portal Hypertension
Principal SponsorUniversidade Federal do Rio de Janeiro
Study ContactGuilherme FM Rezende, MD, PhDMore contacts
Last updated: January 28, 2026
Sourced from a government-validated database.Claim as a partner

Protocol

This section provides details of the study plan, including how the study is designed and what the study is measuring.
Design Details

50 patients to be enrolled

Total number of participants that the clinical trial aims to recruit.

Diagnostic Study

Diagnostic studies focus on improving how we detect or confirm a disease. They test new tools or techniques that could provide faster or more accurate diagnoses.



Eligibility

Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.
Conditions
Criteria

Any sex

Biological sex of participants that are eligible to enroll.

From 18 to 80 Years

Range of ages for which participants are eligible to join.

Healthy volunteers not allowed

If individuals who are healthy and do not have the condition being studied can participate.

Conditions

Pathology

Idiopathic Noncirrhotic Portal HypertensionDigestive System DiseasesHypertension, PortalLiver Diseases

Criteria

Inclusion Criteria: * Age ≥ 18 years; * Patients with specific signs of portal hypertension: 1. Endoscopic: esophagogastric/ectopic varices; 2. On imaging (US, CT or MRI): portosystemic collateral veins; * Transient hepatic elastography with valid values ≤ 20 kPa; * Signed written informed consent form. Exclusion Criteria: * Contraindications to HVPG or percutaneous liver biopsy: 1. Pregnancy 2. Allergy to iodine 3. Chronic kidney disease with creatinine clearance \< 50 ml/min 4. Anticoagulation 5. RNI \> 1.5 6. Platelets \< 50,000/mm3 * Confounding factors: 1\. Hepatitis C treated with SVR * Conditions that exclude the diagnosis of PSVD: 1. History of bone marrow transplant 2. Budd-Chiari 3. Congestive heart failure or Fontan surgery 4. Abernethy's Syndrome 5. Hereditary hemorrhagic telangiectasia 6. Chronic cholestatic diseases 7. Neoplastic hepatic infiltration 8. Sarcoidosis 9. Congenital hepatic fibrosis 10. Hepatosplenic schistosomiasis 11. Portal cavernoma / thrombosis with complete occlusion of the main portal vein.

Study Plan

Find out more about all the medication administered in this study, their detailed description and what they involve.
Treatment Groups
Study Objectives

One single intervention group is designated in this study

This study does not include a placebo group 

Treatment Groups

Group I

Experimental
All patients included will undergo HVPG measurement and US-guided percutaneous liver biopsy. The exams will be performed in sequence, in the laboratory of hepatic hemodynamics. Within 4 to 8 weeks, a multiparametric magnetic resonance imaging of the abdomen with elastography will be performed, concluding the protocol.

Study Objectives

Primary Objectives

Secondary Objectives

Study Centers

These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.

This study has 1 location

Suspended

Hospital Universitário Clementino Fraga Filho / Universidade Federal do Rio de Janeiro (UFRJ)

Rio de Janeiro, BrazilOpen Hospital Universitário Clementino Fraga Filho / Universidade Federal do Rio de Janeiro (UFRJ) in Google Maps
SuspendedOne Study Center