In vivo validation of 4D flow MRI for assessing the hemodynamics of portal hypertension

Purpose: To implement and validate in vivo radial 4D flow MRI for quantification of blood flow in the hepatic arterial, portal venous, and splanchnic vasculature of healthy volunteers and patients with portal hypertension. Materials and Methods: Seventeen patients with portal hypertension and seven...

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Bibliographic Details
Published in:Journal of magnetic resonance imaging 2013-05, Vol.37 (5), p.1100-1108
Main Authors: Roldán-Alzate, Alejandro, Frydrychowicz, Alex, Niespodzany, Eric, Landgraf, Ben R., Johnson, Kevin M., Wieben, Oliver, Reeder, Scott B.
Format: Article
Language:English
Subjects:
4D Flow MRI
Aged, 80 and over
Algorithms
Blood Flow Velocity
Female
hepatic hemodynamics
Humans
Hypertension, Portal - etiology
Hypertension, Portal - pathology
Hypertension, Portal - physiopathology
Image Enhancement - methods
Image Interpretation, Computer-Assisted - methods
Imaging, Three-Dimensional - methods
Liver Circulation
Liver Cirrhosis - complications
Liver Cirrhosis - pathology
Liver Cirrhosis - physiopathology
Magnetic Resonance Angiography - methods
Male
Middle Aged
portal hypertension
Reproducibility of Results
Sensitivity and Specificity
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Summary:Purpose: To implement and validate in vivo radial 4D flow MRI for quantification of blood flow in the hepatic arterial, portal venous, and splanchnic vasculature of healthy volunteers and patients with portal hypertension. Materials and Methods: Seventeen patients with portal hypertension and seven subjects with no liver disease were included in this Health Insurance Portability and Accountability Act (HIPAA)‐compliant and Institutional Review Board (IRB)‐approved study. Exams were conducted at 3T using a 32‐channel body coil with large volumetric coverage and 1.4 mm isotropic true spatial resolution. Using postprocessing software, cut‐planes orthogonal to vessels were used to quantify flow (L/min) in the hepatic and splanchnic vasculature. Results: Flow quantification was successful in all cases. Portal vein and supraceliac aorta flow demonstrated high variability among patients. Measurements were validated indirectly using internal consistency at three different locations within the portal vein (error = 4.2 ± 3.9%) and conservation of mass at the portal confluence (error = 5.9 ± 2.5%) and portal bifurcation (error = 5.8 ± 3.1%). Conclusion: This work demonstrates the feasibility of radial 4D flow MRI to quantify flow in the hepatic and splanchnic vasculature. Flow results agreed well with data reported in the literature, and conservation of mass provided indirect validation of flow quantification. Flow in patients with portal hypertensions demonstrated high variability, with patterns and magnitude consistent with the hyperdynamic state that commonly occurs in portal hypertension. J. Magn. Reson. Imaging 2013;37:1100–1108. © 2012 Wiley Periodicals, Inc.
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.23906