Peltec A, Sporea I. Preventive strategies in hepatology: Role of multiparametric assessment of portal hypertension in chronic liver disease. World J Gastroenterol 2026; 32(29): 119106 [DOI: 10.3748/wjg.119106]
Corresponding Author of This Article
Angela Peltec, MD, PhD, Associate Professor, Discipline of Gastroenterology, Department of Internal Medicine, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Str. Testemitanu 29, Chishinev 2019, Moldova. angela.peltec@usmf.md
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Peltec A, Sporea I. Preventive strategies in hepatology: Role of multiparametric assessment of portal hypertension in chronic liver disease. World J Gastroenterol 2026; 32(29): 119106 [DOI: 10.3748/wjg.119106]
World J Gastroenterol. Aug 7, 2026; 32(29): 119106 Published online Aug 7, 2026. doi: 10.3748/wjg.119106
Preventive strategies in hepatology: Role of multiparametric assessment of portal hypertension in chronic liver disease
Angela Peltec, Ioan Sporea
Angela Peltec, Discipline of Gastroenterology, Department of Internal Medicine, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chishinev 2019, Moldova
Ioan Sporea, Department of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300736, Romania
Author contributions: Peltec A contributed to the conception of the review and writing of the manuscript; Sporea I provided important intellectual contributions to the study and various revisions of the manuscript; and all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Corresponding author: Angela Peltec, MD, PhD, Associate Professor, Discipline of Gastroenterology, Department of Internal Medicine, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Str. Testemitanu 29, Chishinev 2019, Moldova. angela.peltec@usmf.md
Received: January 19, 2026 Revised: February 9, 2026 Accepted: April 8, 2026 Published online: August 7, 2026 Processing time: 179 Days and 12.1 Hours
Abstract
The burden of mortality caused by liver disease continues to increase, underscoring the need for preventive hepatology, an emerging subspecialty focused on reducing disease risk and preventing decompensation. Because most chronic liver diseases are incurable, prevention depends on early identification of compensated advanced liver disease and clinically significant portal hypertension to enable timely risk stratification and intervention. This review summarizes the recent evidence on noninvasive imaging for assessing portal hemodynamics, including Doppler ultrasound, contrast-enhanced ultrasound, elastography (liver and spleen stiffness), and endoscopic ultrasound. Multiparametric ultrasonography offers a bedside modality to screen for compensated advanced liver disease/clinically significant portal hypertension and to monitor portal hypertension risk over time. This modality will guide proactive care by identifying patients who need intensified surveillance, prophylaxis, endoscopy, hepatology/transplant referral. It can also assess the patient’s response to etiologic, lifestyle, and portal-pressure–targeted therapies to prevent decompensation and improve outcomes.
Core Tip: The goal of preventive hepatology is to reduce the burden of liver disease through early detection, risk stratification, and timely intervention. Assessing portal hypertension in patients with advanced chronic liver disease is essential for predicting decompensation and guiding clinical management. Noninvasive imaging techniques, particularly multiparametric ultrasound (MPUS), are valuable approaches for evaluating portal hemodynamics. Combining Doppler ultrasound, contrast-enhanced ultrasound, elastography, and endoscopic ultrasound, MPUS enables accurate, accessible, and radiation-free assessment of liver disease severity. The integration of MPUS into routine care will support effective screening and monitoring to ultimately improve outcomes.
