A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls

Zoran Stankovic*, Zoltan Csatari, Peter Deibert, Wulf Euringer, Bernd Jung, Wolfgang Kreisel, Julia Geiger, Maximilian F. Russe, Mathias Langer, Michael Markl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

PURPOSE: To evaluate the feasibility of time-resolved flow-sensitive four-dimensional (4D) MRI for the visualization and quantification of splanchnic arterial and portal venous hemodynamics in patients with cirrhosis and in controls. MATERIALS AND METHODS: We applied flow-sensitive 4D MRI to evaluate arterial and portal venous three-dimensional blood flow in patients with advanced liver cirrhosis (n=5) and in healthy controls (n=10) using 3T MRI (spatial resolution=1.7×2.1×2.4 mm, temporal resolution=62.4 ms). The qualitative flow was analyzed using three-dimensional streamlines and time-resolved particle traces. Retrospective flow was quantified in nine predefined anatomic regions evaluating maximum and mean velocities, the flow volume, the vessel lumen area, pulsatility indices, and resistance indices. Doppler ultrasound (US) was our reference standard. RESULTS: Flow-sensitive 4D MRI visualized liver hemodynamics successfully in 91% of patients and 96% of volunteers with limitations for the patients' extrahepatic vessels (one case of splenic and superior mesenteric veins each) and intrahepatic portal vein branches (in five vessels). Healthy control individuals revealed reduced velocities and larger vessel areas in MRI than in Doppler US. We found no significant differences in the flow volume, pulsatility indices, and resistance indices on comparing MRI with US. Regional flow quantification within the splanchnic system of healthy volunteers and liver cirrhosis patients revealed an increase in the inflow (up to 65%), but a decrease in the patients' outflow (up to 37%). CONCLUSION: Flow-sensitive 4D MRI is feasible for profound evaluation of arterial and portal venous hemodynamics in liver cirrhosis patients, providing additional information on the pathophysiology of the altered splanchnic system.

Original languageEnglish (US)
Pages (from-to)669-675
Number of pages7
JournalEuropean Journal of Gastroenterology and Hepatology
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2013

Keywords

  • 4D MRI
  • liver cirrhosis
  • liver hemodynamics
  • splanchnic system

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint

Dive into the research topics of 'A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls'. Together they form a unique fingerprint.

Cite this